Hospitals are just starting to come to grips with the reality that they must pay attention to patient-reported outcomes, but they have a lot of catching up to do.
Just 18 percent of hospitals always consult patient-reported outcomes when making clinical decisions and setting care guidelines, according to a survey of hospital executives, conducted by Salt Lake City-based analytics firm Health Catalyst. Still, that is a higher rate than some expected.“I was actually surprised that 18 percent were actually using it all the time,” said Dr. Caleb Stowell, vice president of standardization and business development for the International Consortium for Health Outcomes Measurement (ICHOM). ICHOM, of Cambridge, Massachusetts, helps set standards for reporting on health outcomes. The organization did not participate in the survey, but does work with Health Catalyst.Still, 72 percent of hospitals that said they “rarely” or “never” consider patient-reported outcomes indicated that they intend to start doing so regularly in the next 1-3 years as healthcare moves from fee-for-service to value-based payment. Of the need to embrace value-based care, Stowell said, “We’ve sold it.”Patient-reported outcomes seem to be the next horizon in quality reporting and scoring. To date, reports on outcomes and patient safety have mostly indicated whether a hospital has harmed individuals, not how patients perceive care or whether treatment improved their quality of life.Patient-reported outcomes have long been prevalent in research and clinical trials. In clinical care, however, there have only been “fairly rudimentary applications so far,” Stowell said.That is changing. Notably, the Centers for Medicare and Medicaid Services already incorporates patient-reported outcomes into its value-based payment program for knee and hip replacements, though reporting is voluntary for now. But the Merit-based Incentive Payment System (MIPS), which is scheduled to take effect in 2019, will consider patient-reported outcomes in the calculation of Medicare payments to physicians.“It will be a journey,” Stowell said. “But I think most people see this as the writing on the wall,” Stowell said.