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Table 1 Planning phase of PROMs collection implementation initiative

From: Electronic health record–integrated approach for collection of patient-reported outcome measures: a retrospective evaluation

Process

Key Questions

Options for Implementation

Identified Implementation Strategy

Integration

What strategy will be used for integrating PROMs in EHRs?

Minimal: Staff or clinicians manually enter PROMs data into the EHR (e.g., paper scanning, clinical note entry); many variations of this exist

Full integration approach to PROMs collection

  

Third-party: PROMs can be collected through a specific vendor interface and mapped to the EHR into discrete fields.

 
  

Full integration: PROMs are collected from the patient and reported directly within the EHR

 

Governance

How will the PRO-EHR system be governed?

Centralized: PROMs governed by COORDS stakeholder group

Centralized governance by the multidisciplinary group

  

Distributed: PROMs governed at the division level

 

Ethical considerations

What is the intended use of PROMs data?

Patient care, research, and/or population surveillance

PROMs collection as part of standard of care for primary use in patient care and population health

 

How will patient privacy and burden be managed?

Patient information collected as part of standard of care or request informed consent

Safeguards embedded in EHR to protect against redundant data collection and unauthorized access

PROMs data extraction and storage

How can PROMs data from multiple EHRs be pooled?

How can data be structured and stored to support various efforts?

Local datamart: PROMs data are stored locally, and a data model is created to outline the PROMs data to be shared across institutions

Centralized data warehouse: Data from each local EHR are stored in one location

Local datamart with a data model developed to routinely extract PROMs directly from the EHR along with other clinically relevant data

  1. COORDS Comprehensive Outcomes in Orthopaedics and Rehabilitation Data System, EHR electronic health record, PROMs patient-reported outcome measures