Improving clinic efficiency through tablet-based electronic patient reported outcomes (ePRO)

Background: Patient reported outcomes (PROs) can be used to improve clinical care and aid research efforts. Advances in technology have allowed collection of patient reported outcomes electronically (ePROs).

Purpose: The aim of this study was to test the feasibility of using a web-based application on an ipad to collect ePROs and send data directly into the electronic health record (EHR) with a general patient population in a busy primary care community health center.

Methods: A convenience sample of 105 patients across 4 provider panels at Fenway Health’s main clinic were approached between January and June 2013 to complete a voluntary assessment which included the PHQ-9 depression screening and a tobacco use screening. One day a week, all patients on the selected provider panels were asked to participate.

Results: Of 105 patients asked to fill out the assessment, 102 patients completed it and 3 patients refused. The median response time was one minute and 30 seconds. Of those who completed the assessment, 57% were male, 69% were white, the age range was 18 – 85 years, and the mean age was 39. 23% of the study population reported moderate to severe depression, 30% reported current tobacco use, and 13% reported former tobacco use. 10% of ePRO respondents who reported their tobacco use on the assessment did not previously have tobacco use recorded in their chart.

Conclusions: Benefits of collecting electronic patient reported outcomes include improved workflow efficiency, reduced data entry errors, decreased clinical paper burden, improved patient-provider communication, and access to real-time data within patient’s electronic medical records. It is highly feasible to implement ePROs with minimal training in a busy primary care facility with short wait times in order to collect a wide array of patient measures, including those mandated by patient-centered medical home and meaningful use.