Systematic measurement of patient-reported outcomes (PROM) through an electronic device in the University Hospital 12 Octubre: Study of patient acceptance and feasibility (Preprint)
Authors: Salamanca-Castro Ana Belén , Varela-Rodríguez Carolina , Canto Marcelle , Espallargas-Moya Pilar , Ruiz-López Pedro Miguel 
Published: October 2022

BACKGROUND

Traditional clinical effectiveness indicators provide a partial view of healthcare quality. The patient-reported outcomes measures (PROM) evaluate the psychological and social impact of the illnesses on the patient's daily activities. The systematic use of PROM encourages the healthcare system to focus on the patient and align with Evidence-Based Clinical Practice (EBM) and with Value-Based Healthcare (VBHC). Nowadays, web-based applications and smartphone apps are the main methods used to record data for the EHR, give health information and education, and collect PROMs worldwide. Nevertheless, the target population's characteristics, low socioeconomic incomes, might likely influence the performance of the PROM collection.

OBJECTIVE

Thus, the specific objectives were to approach the patients' acceptability of the questionnaires, evaluate the potential barriers to the use of electronic, assess the comprehension of the questionnaires, and identify the potential accuracy of data. Besides, we specifically aimed to know the appropriate timing for applying the questionnaires.

METHODS

Discussion groups with patients attending the University Hospital 12 de Octubre oncology department. Convenience sampling was based on the accessibility to the patients and patients' capacity or willingness to participate. Category saturation determined the final sample size. The data analysis was performed by an open, selective, and axial codification. The participants received the results of the analysis to verify the grade on which their discourses were adequately analyzed.

RESULTS

One critical aspect of innovation success is the acceptability of the target population (patients) influenced by the meaning of the project and the perceived benefit. Acceptability determines latent categories such as patient engagement and comprehension of the questionnaire. Comprehension and engagement seem to be latent variables linked to precision and accuracy. Regarding the potential barriers identified, the patients themselves asked for alternative formats to participate in the collection (e.g., paper versions of the questionnaires).
Our results showed a majority of acceptance among participants, who understood it as a sign of interest in their well-being, understanding that it will increase and enable the communication between professionals and patients. The participants highlighted that some essential health topics are not mentioned unless there is an empathic connection with the professional. PROMs acted as icebreakers empowering the patient to talk about intimate content without needing an empathic relationship. The patients stated that the first questionnaire should be applied 10-15 days after the diagnosis. So, they have time to understand and believe the diagnosis.

CONCLUSIONS

In conclusion, our patients saw PROMs as tools that enable a humanized model of care, where the patient is attended to from a holistic perspective. PROMs also provide fluent communication between the patients and healthcare professionals, which our participants understand as patient-centred attention