The tool collects patient-reported outcomes measures as well as reports from providers to produce a reliable measure of clinical quality.
A new patient-reported outcomes measurement tool may portray a more accurate picture of care quality by more reliably representing both patient and physician perceptions of treatment outcomes, according to researchers from the Mayo Clinic.
The measurement, developed by Shawn O’Driscoll, MD, an orthopedic surgeon at the Mayo Clinic, aims to produce a more reliable measure of clinical quality as reported by both patients and providers. Too often, there is a disconnect between how patients and providers perceive care outcomes, and that is usually because of a measurement failure.
“There is no single gold standard among outcome scoring systems,” O’Driscoll said in a statement. “One of the challenges of scoring systems is their specificity to a given patient population, procedure, or diagnostic category. As a result, they’re not as useful when applied to other circumstances.”
O’Driscoll developed the Summary Outcome Determination (SOD) Score, which looks at how both patients, their physicians, and members of the medical team perceive care outcomes.
The SOD asks patients, physicians, and a member of the medical team to each fill out a standardized form. This will allow the measure to utilize a patient-provider agreement index that looks at the extent to which patients and providers agree on care quality.
Each stakeholder answers questions ranking clinical quality on a scale of ten to minus ten. Additionally, patient, physicians, and care team members look at specific categories related to care, describing care as anything from normal to leading to death.
This approach has yielded more reliable and therefore more usable patient-reported outcomes, O’Driscoll and a Mayo Clinic research team found in a recent pilot study, which will be published in the July edition of Mayo Clinic Proceedings.
O’Driscoll and colleagues looked at responses from 100 patients and their clinical teams an average of 31 months following an elbow or shoulder surgery. The team used the 31-month follow-up benchmark to understand the low-term outcomes of a surgery.
An analysis of SOD responses revealed that patients and providers largely agreed on care quality. The measure yielded a 96 percent agreement rate in the numerical ranking categories.
The measure was not quite as reliable when looking at the qualitative categories. Patients and providers disagreed in 34 of the categories. However, in a majority of these cases, the disparity stemmed from providers underestimating the quality of care. In nearly three-quarters of disagreements, the patient rated care as better than the provider did.
“When physicians and patients differed in their reported outcomes, the SOD assigned by the (patient) was higher than the score assigned by the physician 72 percent of the time,” the study authors wrote.
Ultimately, the reliability of the score will be promising for providers who want to better understand the quality of care they deliver to patients. Specifically, the tool can help providers understand how patients usually feel following a surgery.
By observing trends in patient-reported outcomes, O’Driscoll said providers can prepare their patients for the after effects of the procedure.
“If the physician can know what the patients generally think of the outcomes, based on scores retrospectively, the physician is in a much better position to address in advance the patient’s likely satisfaction, and adjust treatment and expectations in that direction,” he noted.
What’s more, the SOD scoring methodology will make it easier for providers to educate their patients, O’Driscoll said. Providers have long sought to explain the impacts of a certain medical procedure to their patients. This is a key component to shared decision-making, and ensures patients understand the impact of their care.
The intuitive scoring methodology may make it easier for providers to educate their patients about the potential long-term impacts of a certain procedure.
“When I explain the expected outcomes of a surgical procedure to a patient, I paint a picture of how a group of 100 patients would report outcomes among the nine categories a year or two from now,” O’Driscoll explained. “Patients find that very helpful and easy to understand.”
Creating an accurate and effective patient-reported outcomes measurement will be essential as the medical industry bends toward value-based care, O’Driscoll acknowledged. This will help better demonstrate clinical quality, a factor that ultimately informs a value-based payment.
“We are entering an era in which health care delivery, and payment for such care, will be determined by cost effectiveness,” he concluded. “It will ultimately be patient satisfaction that will drive decisions on care, and we must have a method by which physician satisfaction and patient satisfaction are in close synchrony.”
Date: June 28, 2019
Source: Patient Engagement HIT