Government policy in recent years has clearly outlined the need to involve patients in decisions about their care, and that prudent health care principles and value-based healthcare will be the basis on which healthcare services are planned and delivered. Embedding the right approach to gathering patient reported outcome measures (PROMs) is one vital component in aligning with the policies detailed in ‘A Healthier Wales’, ‘The National Clinical Framework’ and ‘The National Planning Framework’. Without a consistent approach to outcome collection across all Health Boards and Trusts in Wales, these policies become very difficult to deliver fully.
PROMs have been collected for several years, in a variety of ways by clinical teams across many Health Boards and Trusts in Wales. Initially using paper based PROMs, progressing to single specialty electronic platforms. More recently the digital health strategy for Wales has shifted to an open architecture approach which is based on interoperability and data standards. Allowing organisations to diversify their digital solutions to ensure they meet local needs, whilst still supporting the vision of capturing data once and enabling that data to be used multiple times across the system. This vision can only be achieved with a consistent approach to data collection.
There are currently a number of PROMs platforms in use within Wales, collecting across a wide range of different health pathways. Although there are a number of nationally agreed condition specific PROMs forms used within defined populations, there are still high levels of variation in the data collected across different providers and organisations. This is preventing us from having data that can flow across the system easily. Data is held in silos which makes it difficult to link between organisations and ultimately use to provide useful insights that support change to improve patient outcomes. Ensuring that there is a standardised and consistent approach, no matter what platform is being used is why we have created the PROMs Standard Operating Model (PSOM).
PSOM is a robust piece of guidance and toolkits that will enable you and your chosen platform provider to introduce patient reported outcome collection in a way that properly meets the needs of patients, clinicians and health organisations today and beyond. It details the right data, processes and connectivity you’ll need to successfully collect patient reported digital outcomes through Wales’s evolving digital healthcare landscape.
We will shortly deliver an All-Wales PROMs Outcome Collection Framework, which will include a number of suitable suppliers for organisations and teams to choose from, who can all fully deliver to the specification. This Framework will allow all Health Boards and Trusts in Wales to either make a direct award to a supplier on the framework or run a mini-competition from the pool of potential suppliers, if there are additional local requirements. We expect the tender to implement the framework to conclude during the Autumn of 2022.
If we all followed the PSOM when introducing patient reported outcome collection, we would be enabling a whole host of new features and functionality that are beyond what is possible today.
For patients, PSOM would enable a single-sign-on solution for applications to view all of their healthcare data that matters in one place. It would allow patients to view PROMs responses longitudinally, tracking their outcomes over time to support self-management of care. Clinicians could be notified in a timely manner if a patient’s health or condition changes. PSOM would also help patients engage with clinicians more and support shared decision making.
For clinicians, PSOM would enable them to view all completed PROMs for a patient, irrespective of which Health Board/Trusts collected it and viewed longitudinally in an electronic patient record. It would support more structured and targeted conversations with patients, specific to their outcomes and allow for better shared decision making. PSOM would also allow clinicians to be more proactive as they would be able to receive triggers/alerts about changes in their patient’s conditions.
For health organisations, PSOM would be an enabler that supports the delivery of Welsh Government policy initiatives like ‘A Healthier Wales’, ‘The National Clinical Framework’ and ‘The National Planning Framework’. It would simplify the implementation of PROMs in all organisations and potentially generate substantial cost savings. Standardised PROMs data can be analysed alongside other data sources to support intelligent insights that inform planning and other operational decision making.