Patient-reported outcome–based performance measures (PRO-PMs) that are methodologically sound and evidence based have the potential to assess, promote, and reward patient-centered care. They are being incorporated into payment models, and the Centers for Medicare & Medicaid Services Meaningful Measures 2.0 initiative includes development of PRO-PMs that are embedded into workflow (1). Despite their appeal, PRO-PMs represent only 5% of the measures used in federal reporting programs and endorsed by the National Quality Forum (2). We describe several of the key challenges faced when developing and implementing PRO-PMs.
As patient-centered measures proliferate, it is critical to understand the distinction among terms ...
- 1. Centers for Medicare & Medicaid Services. Meaningful Measures 2.0: Moving from Measure Reduction to Modernization. Accessed at www.cms.gov/meaningful-measures-20-moving-measure-reduction-modernization on 17 March 2021. Google Scholar
- 2. Centers for Medicare & Medicaid Services. CMS Measures Inventory Tool. Accessed at https://cmit.cms.gov/CMIT_public/ListMeasures on 10 July 2020. Google Scholar
- 3. National Quality Forum. Patient-Reported Outcomes in Performance Measurement. 2013. Accessed at www.qualityforum.org/Publications/2012/12/Patient-Reported_Outcomes_in_Performance_Measurement.aspx on 10 July 2020. Google Scholar
MacLean CH, Kerr EA, Qaseem A. Time out - charting a path for improving performance measurement. N Engl J Med. 2018;378:1757-1761. [PMID: 29668361] doi:10.1056/NEJMp1802595 CrossrefMedlineGoogle Scholar
Boyce MB, Browne JP, Greenhalgh J. The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: a systematic review of qualitative research. BMJ Qual Saf. 2014;23:508-18. [PMID: 24505110] doi:10.1136/bmjqs-2013-002524 CrossrefMedlineGoogle Scholar
Squitieri L, Bozic KJ, Pusic AL. The role of patient-reported outcome measures in value-based payment reform. Value Health. 2017;20:834-836. [PMID: 28577702] doi:10.1016/j.jval.2017.02.003 CrossrefMedlineGoogle Scholar
Author, Article, and Disclosure Information
American College of Physicians, Philadelphia, Pennsylvania (A.Q., S.T.)
University of New Mexico School of Medicine, Albuquerque, New Mexico (E.D.B.)
Hospital for Special Surgery, New York, New York (C.H.M.)
Mount Sinai Health System, New York, New York (A.D.)
Huntington Hospital, Huntington, New York (N.F.).
Acknowledgment: The Performance Measurement Committee thanks Sarah J. Dinwiddie, RN, MSN, for her initial support and contributions.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M19-3603.
Corresponding Author: Amir Qaseem, MD, PhD, MHA, American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106; e-mail, aqaseem@acponline.
Current Author Addresses: Dr. Qaseem and Ms. Tierney: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Barrett: UNM School of Medicine MSC08 4720, 1 University of New Mexico, Albuquerque, NM 87131.
Dr. MacLean: Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021.
Dr. Dunn: Mount Sinai Health System, 1468 Madison Avenue, Box 1086, New York, NY 10029.
Dr. Fitterman: Huntington Hospital, 270 Park Avenue, Huntington, NY 11743.
Author Contributions: Conception and design: A. Qaseem, S. Tierney, E.D. Barrett, C.H. MacLean, A. Dunn, N. Fitterman.
Analysis and interpretation of the data: A. Qaseem, E.D. Barrett, C.H. MacLean, A. Dunn.
Drafting of the article: A. Qaseem, S. Tierney, C.H. MacLean, A. Dunn.
Critical revision of the article for important intellectual content: A. Qaseem, E.D. Barrett, C.H. MacLean, A. Dunn, N. Fitterman.
Final approval of the article: A. Qaseem, S. Tierney, E.D. Barrett, C.H. MacLean, A. Dunn, N. Fitterman.
Statistical expertise: A. Qaseem.
Administrative, technical, or logistic support: A. Qaseem.
This article was published at Annals.org on 11 May 2021.
* This paper, written by Amir Qaseem, MD, PhD, MHA; Samantha Tierney, MPH; Eileen D. Barrett, MD, MPH; Catherine H. MacLean, MD, PhD; Andrew Dunn, MD, MPH; and Nick Fitterman, MD, was developed for the Performance Measurement Committee of the American College of Physicians. Individuals who served on the Performance Measurement Committee from initiation of the project until its approval were Nick Fitterman, MD (Chair)†; J. Thomas Cross Jr., MD, MPH (Vice Chair)‡; Eileen D. Barrett, MD, MPH†; Peter Basch, MD‡; Robert M. Centor, MD‡; Andrew Dunn, MD, MPH†; Catherine H. MacLean, MD, PhD†; Robert M. McLean, MD‡; Danny Allen Newman, MD‡; Sameer D. Saini, MD, MS‡; Paul G. Shekelle, MD, MPH, PhD‡; and Sandeep Vijan, MD, MS‡. Approved by the ACP Board of Regents on 9 February 2021.
‡ Nonauthor contributor.