Patient-Reported Outcomes Measurement Information System Integration Into Rheumatology Clinical Practice

Study Overview
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Brief Summary
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This study will examine the impact of providing patient-reported outcomes measurement information system (PROMIS) scores to patients before appointments with their healthcare provider.

Official Title
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Patient-Reported Outcomes Measurement Information System Integration Into Rheumatology Clinical Practice

Conditions
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Rheumatic Diseases

Intervention / Treatment
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* Behavioral: PRO Integration into Clinical Practice


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria for patients: New and established patients seeking care at Michigan Medicine rheumatology clinics Patients should have access to the patient portal in MiChart patient portal Patients should have access to the internet at home to be able to complete the PROMIS PRO measures and study surveys online Patients should have completed PROMIS pain, physical function, and sleep disturbance measures at least one day before their baseline appointment At least one of the PROMIS PRO scores should be in the concerning zone (pain intensity ≥ 5, physical function ≤ 40, or sleep disturbance ≥ 60). Exclusion Criteria: Non-English speakers under 18 years of age Inclusion Criteria for providers: Rheumatology health care providers, including clinicians and advanced practice providers at Michigan Medicine who are currently treating rheumatology patients Exclusion Criteria: Those not meeting the inclusion criteria

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: There will be two arms (1: 1 randomization) of the trial to assess PRO integration into care
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: PRO Integration into Clinical Practice<br>PRO scores will be shared with patients and healthcare providers (HCPs) via an emailed report card | Behavioral: PRO Integration into Clinical Practice<br>* HCPs will document their discussion and recommendations/referrals in MiChart (Epic EMR)<br>|
| No Intervention: Usual Care<br>Patients and HCPs will not receive an emailed PROMIS score report. PROMIS scores, however, will be available in the EMR as usual. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent of appointments at which Patient-Reported Outcomes Measurement Information System (PROMIS) scores are documented in the electronic medical record (EMR) note by the participating health care provider (HCP) | Documentation in EMR notes will be categorized as either 'yes' or 'no' and identified through EMR data pulls. | Up to 3 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percent of appointments at which referrals/recommendations related to PROMIS scores are documented in the EMR note by the participating HCP | Documentation in EMR notes will be either 'yes' or 'no' and identified through EMR data pulls. | Up to 3 months | 
| Quality of patient-provider communication | Patient-provider communication is measured using the Interpersonal Processes of Care (IPC) Survey (29 items), which measures 7 subscales: hurried communication, elicited concerns/responded, explained results/medications, patient-centered decision making, compassion, discrimination, and disrespectful office staff (score for each subscale ranges from 1-5; a higher score indicates better IPC) | Up to 2 weeks | 
| Change in score of the most bothersome PROMIS domain | Change in the z score of the most bothersome PROMIS domain at baseline . | Baseline, 3 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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PROMIS, Health-related quality of life