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 |