Abstract
Background/Aims Patient-reported outcomes (PROs) provide valuable information to the clinician about the patient’s symptoms and how the patient is responding to treatment. In some cases, electronic or phone-based PROs can reduce the need for office visits. In order to be maximally useful, PROs need to be integrated with electronic health record (EHR) data so providers can evaluate the PRO in the context of a patient’s complete clinical record. In this work we identified methods for integrating PROs into the EHR. We focused primarily on PROs collected through electronic interfaces such as personal health records, email, external websites and standalone apps for smartphones and tablets.
Methods We compared the benefits and drawbacks of different methods for integrating PROs into Epic Systems Corporations’ suite of EHR products. Available methods for automatic integration of PROs into the EHR includes the flowsheet and questionnaire extensions to Epic’s MyChart product and HL7 messaging from external applications such as websites or smartphone/tablet apps.
Results The questionnaire and flowsheet methodologies within Epic’s MyChart product provide a technically simple way to collect PROs. However, these methods are relatively inflexible in terms of how you can present information to the patient. For example, neither method allows you to present images or drawings that can help patients better express concepts such as where symptoms occur in their body. In contrast, website and smartphone/tablet applications can provide much more flexible patient interface options, but the data can be harder to integrate into the EHR system. Regardless of how PROs are collected, integrating the information into the provider’s workflow remains a challenge.
Discussion Multiple methodologies exist for collecting and integrating PROs into the Epic EHR. Major trade-offs include the flexibility of the patient interface and the ease of integrating the data back into the EHR.
