Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach

Montgomery, Nicole; Howell, Doris; Ismail, Zahra; Bartlett, Susan J.; Brundage, Michael; Bryant-Lukosius, Denise; Krzyzanowska, Monika; Moody, Lesley; Snyder, Claire; Barbera, Lisa

doi:10.1186/s41687-020-00270-1

Journal of Patient-Reported Outcomes

Table 1 PROM implementation evaluation process and core considerations

From: Selecting, implementing and evaluating patient-reported outcome measures for routine clinical use in cancer: the Cancer Care Ontario approach

	Consideration	Patient	Provider	Clinic
Acceptability	Relevance/Importance	Patients feel the PROM addresses symptoms that are relevant and important	Providers feel results of the PROM are clinically relevant and amenable to change	The PROM facilitates collection of clinic level data to better understand symptom burden and need for supportive care
	Interpretability	Patients feel the PROM and symptom report are easy to understand/interpret	Providers feel the PROM scores and symptom report are easy to interpret	The PROM facilitates real-time bi-directional flow of information between patients and care providers
	Clinic Flow Integration	Patients feel the PROM is easy to complete (not too long)	Providers feel the PROM is concise (enough time to address scores)	The PROM can be easily integrated in clinic flow and completed < 11 min
Outcomes	Communication	Patients feel PROM helps them communicate their symptoms to their care providers	Providers feel the PROM helps facilitate discussion with patients about their symptoms	The PROM facilitates communication between providers (within and between disciplines)
	Symptom Recognition	Patients feel their PROM scores help providers acknowledge their symptoms of concern	Providers feel the PROM scores help to ensure symptoms of concern are recognized	The PROM facilitates shared understanding and decision-making between patients and providers
	Focused Symptom Assessment	Patients feel the PROM helps providers focus and track symptoms that matter most to them	Providers feel the PROM scores help focus the visit on symptoms of concern	The PROM facilitates efficiency by focusing visit time on symptoms of most concern/severity
	Appropriate intervention/Referral	Patients feel the PROM scores help ensure their most bothersome symptoms are being addressed	Providers feel the PROM scores help ensure the most bothersome symptoms have been addressed	The PROM facilitates appropriate intervention (triage/referrals)
	Perceived Value-add	Patients feel the PROM adds to their care and is worth completing	Providers feel the PROM adds value to their practice	The PROM is perceived to be a valuable component of patient care throughout the clinic (clinic culture)
Sustainability	Potential for Embedding in Routine Practice	Patients feel completing the PROM is a routine part of their clinic visit	Providers feel addressing PROM scores is a routine part of the clinic visit (and their practice)	The PROM fits in the model of care, has become normalized within the clinic operations, and is supported by leadership
Sustainability	Support and Resources	Patients feel there is sufficient support to complete the PROM (volunteers, technology, patient symptom guides)	Providers feel there is sufficient resources to support PROM use (staff, hardware, education, symptom guides etc.)	Routine PROM completion is a priority within the clinic (allocated sufficient human and technical resources)

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