Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Oct 30, 2019
Date Accepted: Jun 13, 2020
Date Submitted to PubMed: Jun 19, 2020
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Integration Of Electronic Patient-Report Outcomes Technology Into Routine Primary Care in a Boston Community Health Center
ABSTRACT
Background:
Electronic patient reported outcomes (ePROs) can improve health outcomes by detecting health issues or risk behaviors that may be missed when relying on provider elicitation.
Objective:
To implement an ePRO system asking key health questionnaires in an urban community health center (CHC) in Boston, Massachusetts.
Methods:
An ePRO system asking key health questionnaires was implemented in an urban CHC in Boston, Massachusetts. The system was integrated with the electronic health record so medical providers could review and adjudicate patient responses in real-time during the course of the patient visit. This implementation project was accomplished through careful examination of clinical workflows and a graduated roll-out process that was mindful of patient and clinical staff time and burden. Patients responded to questionnaires using a tablet at the beginning of their visit.
Results:
The system was tested on the patient panel of twenty-five providers. ePRO session completion totals increased considerably, from 2,428 completed sessions in 2014 to 19,650 in 2018. In CY 2018, via ePRO, 41% of patients reported mild-to-severe depression, 35% mid-to-severe anxiety, 35% problem alcohol use, 4.4% positive DAST (drug use) score, and 10% current or some day tobacco use.
Conclusions:
Our program demonstrates that implementation of an ePRO system in a primary care setting is feasible, allowing for facilitation of patient-provider communication and care. Other community health centers can learn from our model in applying technological innovation to streamline clinical processes and improve patient care.
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