A new study in the Journal of Oncology Practice surveys practices within ASCO’s Quality Oncology Practice Initiative (QOPI®) to learn about real world implementation and use of Patient Reported Outcomes (PROs). The survey yielded valuable information on the perception of PROs among oncology practices and the data currently being collected.

PROs are data collected directly from patients to help measure their physical, mental, and social wellbeing. Previous literature has outlined how PROs can be of particular use in oncology with the potential to measure and improve the patient’s care experience in real-time and improve long-term outcomes. The growing presence of PROs in the literature and technology field has elevated the interest of implementing them into practice.

While the interest has grown, little is actually known about the practice level implementation of PROs including how they are collected, measured, and used. Study authors sought better understanding of the real-world use of PROs through QOPI® registered practices. QOPI® is ASCO’s free oncologist-led, practice-based quality assessment program, which is open to all practices with at least one ASCO member. The initiative has helped more than 1,000 practices to date conduct self-examination and identify specific areas for quality improvement.

QOPI® practices serve as a network of leaders in quality assessment that have valuable insights in various areas of data collection and monitoring as participants select from a robust library of quality metrics, submit data through a collection tool, and use results to inform their next quality improvement projects.

QOPI® participants were surveyed with multiple choice and short answer questions via email on why cancer clinics are collecting PROs, which PROs are being collected, and what benefits practices believe their collection will bring. In addition, the practices that were collecting PROs were asked about the challenges they have faced.

They survey found that of evaluable survey responders, 47% collected both PROs and medical history data, 21% collected strictly PROs, 16% collected medical history only, and 16% collected neither.

• Among PRO collectors, the most frequently cited challenge was patient unwillingness to report, followed by insufficient staffing, and patient inability to report PROs due to language, literacy, health status or similar reasons. For non-collectors, challenges to implementation included insufficient staffing, patient unwillingness to report, and lack of PRO integration with the EHR.
• The top three measured PROs were patient distress, disease-specific symptoms, and patient-reported experience/ satisfaction. The average number of PROs collected per practice were 3.9. Collection methods varied, with most collectors using homegrown questionnaires. Frequency of measurement also varied with most measuring more than once—66% surveyed patients at each care encounter, 8% measured monthly, and 17% measured at another interval.
• When asking practices to rate the importance of measuring patients at a certain point of care, the survey found that during active treatment was the most important, followed by the initial visit and during a subsequent non-treatment visit.
• Collection methods included in-practice collection as the most common method, with a majority using paper. Of outside of clinic collectors, a majority used paper via mail. Of collectors at large, 43% used an electronic platform with about half measuring through an EHR-integrated platform.

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