AHRQ Releases Source Code for Patient-Reported Outcomes App
In March Healthcare Innovation reported that an app called PRISM had won the Agency for Healthcare Research and Quality’s Step Up App Challenge, a competition to address the need for greater use of standardized patient-reported outcomes (PRO) data in clinical care and research. Now AHRQ has released the open source code behind the app.
The goal of the Step Up App challenge was to develop a user-friendly app capable of collecting standardized PRO data in various ambulatory settings, including primary and specialty care. PRO data include any information on the status of a patient’s health condition that comes directly from the patient, without interpretation of the patient’s response by a clinician or other medical expert. These data can yield insights into health status, function, symptom burden, adherence, health behaviors and quality of life.
PRISM—an acronym for PROMIS Reporting and Insight System from Minnesota—was developed by a multi-disciplinary team, including members from the University of Minnesota, Fairview/HealthEast Kidney Stone Institute, EMF Consulting, and digital health company PerkHealth. It offers doctors, nurses, and other clinicians a way to collect standardized PRO data from patients in both clinical and non-clinical settings. Among its unique features, PRISM shows how a patient’s data compare with other patients of similar age and gender.
At the time the winner of the challenge was announced, AHRQ issued a statement from Andrew Portis, M.D., of Fairview Health System/HealthEast Kidney Stone Institute, who said that “Validated patient-reported outcome instruments, like the PROMIS measures, capture the subjective patient experience. Yet adoption gaps remain as they can be unnecessarily arduous to implement, collect and analyze data,”
After it won the Step Up App Challenge, PRISM was tested in nine practice settings affiliated with MedStar Health in Washington, D.C., Maryland, and Virginia. The AHRQ-supported pilot testing demonstrated various factors critical to the successful adoption, potential scaling, and sustained use of this technology in ambulatory care settings. The MedStar pilot demonstrated how to structure an efficient technical architecture to make PRO data usable within three EHR systems.
Results of the pilot test included examples of patients’ responses. As one patient remarked, “I liked when the doctor pulled it up. That was eye opening. Game changer... I would love for my doctor to know my interest in my health. It makes it a real partnership. It’s not just your doctor telling you information and you listening. It makes you an active participant.”
In a blog post on the agency website, AHRQ Director Gopal Khanna noted that the PRO research that AHRQ is supporting is promising. “The technology to collect PRO data in a standardized manner and integrate the data into EHR systems is still young but, with AHRQ support, is advancing rapidly,” he wrote. “Standardized and interoperable PRO data can be shared among providers so that patients do not need to complete duplicate surveys during different clinic visits. Its potential to improve whole-person care with a 360-degree view of the patient is enormous. In this COVID-19 age, it’s critical that patients communicate all of their relevant health data to clinicians in a timely, usable fashion so they can be treated appropriately. PRISM is an example of a digital solution for how PRO data can be used to improve quality and care delivery and can empower patients to better manage their health.”
