McLeod Health of South Carolina is building a systemwide joint replacement patient-reported outcome (PRO) data registry. In addition to the PRO data, McLeod’s registry contains implant, comorbidities, and other relevant patient and procedure specific information that allows for risk stratification and granular reporting.
McLeod Health has seven hospitals extending from the Midlands to the Coast along the border of North and South Carolina with locations in Florence, Darlington, Dillon, Manning, Cheraw, Loris, and Little River. McLeod expanded into the Myrtle Beach area for patients looking for primary care and family physicians. Their patient care team consists of more than 800 physicians, 2,000 registered nurses and 8,500 employees.
The health system has partnered with a Minneapolis-based company called Code Technology on the PRO registry. Code focuses on collecting, reporting, and benchmarking PRO data as a service. Since going live with Code on Nov. 30, 2020, McLeod is enrolling an average of 115 total joint replacement patients and 95 PROs per month. Within a year, McLeod Health said it will have a robust and powerful data registry with nearly 1,500 completed PROs.
“PROs are one of the most important tools we have for ensuring we are providing the best care for our patients,” explained Chad Thurman, M.D., an orthopaedic surgeon at McLeod Health in a statement. “By analyzing how our patients are doing before and after surgery, we can continue to make changes to get better.”
Melissa Brock, an orthopaedic navigator at McLeod said PROs give McLeod an idea of how the patient perceives they have improved after surgery. “I believe it’s most important that the patient is satisfied with their recovery. This tool also allows the patient to give their own feedback and make comments on specific areas of their experience,” she said in a statement. “For example, the education process prior to surgery, the response of the nursing staff in the hospital and the interaction they have with their physician. These comments help us to improve many areas of the care they receive.”
A few years ago, in the New England Journal of Medicine Catalyst, Neil Wagle, M.D., M.B.A., wrote about the five-year effort at Partners HealthCare to implement patient-reported outcomes measures (PROMs) of clinical quality.
As Wagle, who was Partners’ medical director for quality, safety and value, pointed out, despite the proliferation of clinical performance measures, most capture the process of care but fail to capture the very reason that most patients seek care: to improve their symptoms.
“PROMs are precisely the missing link in defining a good outcome,” he wrote. “PROMs are the outcome of relevance in nearly every diagnosis, including many in specialties that currently lack good quality measures. By making PROMs an integral part of clinical care, providers can use them to improve an individual patient’s care as well as in aggregate to improve care of a population.” But he noted that health systems have been slow to adopt PROMs due to technological and operational barriers. A platform to gather patient input has to be integrated into the EHR, he wrote, so that results flow into the point of care in real time in order to be actionable. PROMs must fit into provider workflows to be widely adopted.
