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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