The Agency for Healthcare Research and Quality (AHRQ) has released an open source code used to develop the PRISM app—a mobile app that guides patients through questions about their health status and enables Patient-Reported Outcome (PRO) data to be exported in a standardized format, so patients’ health status can be easily shared with providers during the clinical visit, states an agency blog post by Gopal Khanna, M.B.A.
The time patients spend with their healthcare providers is limited. Often missing from the clinical encounter is information about how people fare as they go about their daily lives. It has been challenging to capture and share this reservoir of information due to lack of standards and easy-to-use data collection tools.
PRO data consist of any information on health status that comes directly from the patient, without interpretation by a clinician. These data yield important insights into patients’ function, symptom burden, health behaviors, and quality of life. The collection of standardized PRO data is important because standardized data can be shared and integrated into different electronic health record (EHR) systems more easily. This can improve patients’ engagement with their care and ultimately the quality of care.
The PRISM app is an invention derived from a unique, multi-stakeholder collaborative to foster innovation by bringing together government, delivery systems, innovators, and academia. It was the winning entrant in AHRQ’s Step Up App Challenge, the first of a series of competitions sponsored by the Agency to encourage the development of innovative technologies for providing patient-centered, 21st-century healthcare.
PRISM (PROMIS Reporting and Insight System from Minnesota) was developed by a multi-disciplinary team, including members from the University of Minnesota, Fairview/HealthEast Kidney Stone Institute, EMF Consulting, and digital health company PerkHealth. It offers doctors, nurses, and other clinicians a way to collect standardized PRO data from patients in both clinical and non-clinical settings. Among its unique features, PRISM shows how a patient’s data compare with other patients of similar age and gender.
PRISM was tested in nine practice settings affiliated with MedStar Health in Washington, DC, Maryland, and Virginia. As summarized in a recently released report, this AHRQ-supported pilot testing demonstrated various factors critical to the successful adoption, potential scaling, and sustained use of this technology in ambulatory care settings. Importantly, the MedStar pilot demonstrated how to structure an efficient technical architecture to make PRO data usable within three EHR systems.
Feedback from patients during the pilot test showed that the PRISM app improved patients’ care experiences. As one patient remarked, “I liked when the doctor pulled it up. That was eye opening. Game changer... I would love for my doctor to know my interest in my health. It makes it a real partnership. It’s not just your doctor telling you information and you listening. It makes you an active participant.”
In this COVID-19 age, it’s critical that patients communicate all of their relevant health data to clinicians in a timely, usable fashion so they can be treated appropriately. PRISM is an example of a digital solution for how PRO data can be used to improve quality and care delivery and can empower patients to better manage their health. It’s an innovation that I believe clinicians and patients will regard as invaluable.
