National Implementation of an Electronic Patient-Reported Outcome Measures Program for Joint Replacement Surgery: Pilot Study (Preprint) Article Swipe

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Emma Heath , Ilana N. Ackerman , Michelle Lorimer , Sophia Rainbird , Grace O’Donohue , Andrew Brock , Stephen E. Graves , Ian A. Harris · YOU? · · 2021 · Open Access · · DOI: https://doi.org/10.2196/preprints.30245

BACKGROUND There is a global emphasis on expanding data collection for joint replacement procedures beyond implant attributes and progression to revision surgery. Patient-reported outcome measures (PROMs) are increasingly considered as an important measure of surgical outcomes from a patient’s perspective. However, a major limitation preventing wider use of PROMs data in national data collection has been the inability to systematically collect and share electronic information with relevant stakeholders in a comprehensive and financially sustainable manner. OBJECTIVE This study reports on the development of an electronic data capture and reporting system by a national registry for the collection of PROMs and the processes used to identify and overcome barriers to implementation and uptake. The study also aims to provide a cost breakdown of establishing and maintaining a nationwide electronic PROMs program. METHODS Between 2018 and 2020, 3 governance and advisory committees were established to develop and implement a PROMs pilot program nested within a nationwide joint replacement registry. The program involved electronic collection of preoperative and 6-month postoperative data for hip, knee, or shoulder replacement surgery from 44 Australian hospitals. Resource requirements for the program included a project manager, software developers, data manager, and statistician. An online platform was tested, refined, and implemented for electronic PROMs collection with scalability considered for future expansion to all Australian hospitals and additional data fields. Technical capabilities included different access for multiple user types, patient registration, automatic reminders via SMS text messages and email, online consent, and patient outcome real-time dashboards accessible for different user groups (surgeons, patients, hospitals, and project stakeholders). RESULTS During the PROMs pilot period there were 19,699 primary procedures undertaken with 10,204 registered procedures in the electronic system. This equated to 51.80% of people who had a joint replacement at participating hospitals during this period. Patient registration and data collection were efficient (20-30 seconds and 10-12 minutes, respectively). Engagement with the reporting dashboards (as a proportion of those who viewed their dashboard) varied by user group: 197/277 (71.1%) hospital administrators, 68/129 (52.7%) project stakeholders, 177/391 (45.3%) surgeons, and 1138/8840 patients (12.9%). Cost analysis determined an overall cost per patient of Aus $7-15 (approximately US $5-12) for 2 PROMs collections per joint replacement procedure once the program was established. CONCLUSIONS Successful implementation of an orthopedic PROMs program with planned scalability for a broader national rollout requires significant funding and staffing resources. However, this expenditure can be considered worthwhile, given that collection and reporting of PROMs can drive health care improvement processes. Further consideration of strategies to improve stakeholder engagement with electronic reporting dashboards (particularly for patients and surgeons) will be critical to the ongoing success of a national PROMs program.

Type

preprint

Language

en

Landing Page

https://doi.org/10.2196/preprints.30245

OA Status

gold

References

1

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10

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https://openalex.org/W4206613127

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https://openalex.org/W4206613127

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DOI

https://doi.org/10.2196/preprints.30245

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Title

National Implementation of an Electronic Patient-Reported Outcome Measures Program for Joint Replacement Surgery: Pilot Study (Preprint)

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Type

preprint

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Language

en

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Publication year

2021

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Publication date

2021-05-07

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Authors

Emma Heath, Ilana N. Ackerman, Michelle Lorimer, Sophia Rainbird, Grace O’Donohue, Andrew Brock, Stephen E. Graves, Ian A. Harris

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Landing page

https://doi.org/10.2196/preprints.30245

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Open access

Yes

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OA status

gold

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https://doi.org/10.2196/preprints.30245

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Concepts

Data collection, Electronic data capture, Electronic data, Patient-reported outcome, Resource (disambiguation), Medicine, Computer science, Operations management, Database, Engineering, Nursing, Quality of life (healthcare), Mathematics, Statistics, Computer network

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0

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1

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10

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