JMIR Publications

ABSTRACT

Background:

Patient-reported outcomes (PROs) are increasingly utilized in routine orthopedic clinical care. Computer adaptive tests (CATs) from the Patient-Reported Outcomes Measurement Information System (PROMIS) offer brief and precise assessment that is well suited for collection within busy clinical environments. However, software applications that support the administration and scoring of CATs, immediate access to PRO scores, and minimize clinician burden are not widely available.

Objective:

Our objective was to design, implement, and test the feasibility and usability of a web-based system for collecting CATs in orthopedic clinics.

Methods:

AO Patient Outcomes Center (AOPOC) was subjected to two rounds of testing. Alpha testing was conducted in 3 orthopedic clinics to evaluate ease of use and feasibility of integration in clinics. Patients completed an assessment of PROMIS CATs and a usability survey. Clinicians participated in a brief semi-structured interview. Beta phase testing evaluated system performance through load testing and usability of the updated version of AOPOC. In both rounds of testing, user satisfaction, bugs, change requests, and performance of PROMIS CATs were captured.

Results:

Patient feedback supported the ease of use in completing an assessment in AOPOC. Across both phases of testing, clinicians rated AOPOC as easy to use, but noted difficulties in integrating a web-based software application within their clinics. PROMIS CATs performed well; the default assessment of 2 CATs was completed quickly (mean=9.5 items) with a satisfactory range of measurement.

Conclusions:

AOPOC was demonstrated to be an easy to learn and easy to use software application for patients and clinicians that can be integrated into orthopedic clinical care. The workflow disruption in integrating any type of PRO collection must be addressed if patients’ voices are to be better integrated in clinical care.