Implementation of a patient-reported outcome measure based digital journey and automation tool: A feasibility study in a surgical setting.

Abstract

Background: Patient blood management (PBM) has been shown to improve patient outcomes and optimise resource use. However, the systematic collection and analysis of patient-reported outcome measures (PROMs) remains challenging, limiting their integration into PBM pathways and into value-based healthcare (VBHC) strategies.

Objectives: This study aims to evaluate the feasibility and adherence to an automated VBHC digital tool for PROMs collection in a population of cardiac surgical patients, within the context of PBM implementation.

Design: A single-centre, pragmatic, prospective feasibility study.

Setting: A tertiary Portuguese hospital considering data from 1 March to 6 September 2024. A total of 12 professionals were actively involved in the patient journey design.

Patients: A total of 221 patients (65.2% men, mean age 66.7 ± 9.9 years) with a scheduled cardiothoracic surgery were included.Main outcome measures: Percentage of planned interactions successfully completed.

Results: A two-phase digital PROMs journey was implemented in less than 2 months. A total of 638 interactions were completed by 221 patients, resulting in a global completion proportion of 72.1%. 36-Item Short Form Survey Instrument (SF-36) and BPI questionnaires, completed by 77% of patients, results at 90 days compared to results at initial evaluation (SF-36 physical: t = -0.424, P = 0.681; mental: Z = 33.0, P = 1.000; Brief Pain Inventory (BPI) Pain Severity and Interference: Z = 23.0, P = 0.646). The PHQ-9, completed by 76% of patients, identified five severe and nine moderately severe depression cases. Educational content had a 73.9% reading completion proportion across 303 views.

Conclusions: We showed the feasibility of implementing a digital tool to monitor patient PROMs, along with its adoption by patients and health professionals. This strategy has the potential to contribute to improving healthcare professionals' motivation, access to real-world data, personalised monitoring, and allowing for faster implementation of corrective actions, with an impact on patients' outcomes and costs.