Patient-Centered Outcomes Measurement: Does It Require Information From Patients?

Authors

Leif I. Solberg, HealthPartners Institute for Education and ResearchFollow
Stephen E. Asche, HealthPartners Institute for Education and ResearchFollow
John Butler, HealthPartners Medical GroupFollow
David Carrell, Group Health Research InstituteFollow
Christine K. NortonFollow
Jeffrey G. Jarvik, University of WashingtonFollow
Rebecca Smith-Bindman, University of California, San FranciscoFollow
Juliana O. Tillema, HealthPartners for Education and ResearchFollow
Robin R. Whitebird, University of St. ThomasFollow
Ann M. Werner, HealthPartners Institute for Education and ResearchFollow
Jeanette Y. Ziegenfuss, HealthPartners Institute for Education and ResearchFollow

Publication Date

11-6-2017

Keywords

electronic health records, patient-reported outcomes, patient-centered care

Abstract

Purpose: Since collecting outcome measure data from patients can be expensive, time-consuming, and subject to memory and nonresponse bias, we sought to learn whether outcomes important to patients can be obtained from data in the electronic health record (EHR) or health insurance claims.

Methods: We previously identified 21 outcomes rated important by patients who had advanced imaging tests for back or abdominal pain. Telephone surveys about experiencing those outcomes 1 year after their test from 321 people consenting to use of their medical record and claims data were compared with audits of the participants’ EHR progress notes over the time period between the imaging test and survey completion. We also compared survey data with algorithmically extracted data from claims files for outcomes for which data might be available from that source.

Results: Of the 16 outcomes for which patients’ survey responses were considered to be the best information source, only 2 outcomes for back pain and 3 for abdominal pain had kappa scores above a very modest level of ≥ 0.2 for chart audit of EHR data and none for algorithmically obtained EHR/claims data. Of the other 5 outcomes for which claims data were considered to be the best information source, only 2 outcomes from patient surveys and 3 outcomes from chart audits had kappa scores ≥ 0.2.

Conclusions: For the types of outcomes studied here, medical record or claims data do not provide an adequate source of information except for a few outcomes where patient reports may be less accurate.

Recommended Citation

Solberg LI, Asche SE, Butler J, Carrell D, Norton CK, Jarvik JG, Smith-Bindman R, Tillema JO, Whitebird RR, Werner AM, Ziegenfuss JY. Patient-centered outcomes measurement: Does it require information from patients? J Patient Cent Res Rev. 2017;4:221-9. doi: 10.17294/2330-0698.1456