The Data You've Been Missing — Provided by Patients

Ask orthopedic surgeon Andrew Jawa, M.D., when his total shoulder replacement patients can expect to put on a jacket without help. His answer is likely to include the exact postoperative week — with evidence-based variations due to each patient's age and condition. Jawa performs more than 220 total shoulder replacements each year at the Boston Sports and Shoulder Center. And his success relies in part on self-reported data provided by his patients at every visit, from the first preoperative appointment through every follow-up visit for the next five years. That longitudinal data enables him to predict with precision each patient's rate of recovery.

It's an example of the growing use of patient-reported outcome measures, or PROMs: Comprehensive questionnaires for patients measuring their perceptions of their level of pain and degree of function. Once a tool for researchers in clinical trials and to collect data for registries and national benchmarks, PROMs are being adopted by clinicians across the country — from surgeons to primary care providers — to guide and evaluate care delivery.

The process is reshaping patient encounters. The results are guiding clinical decision-making. And, eventually, patient-reported data may even change the way physicians are paid. "I think that's the way healthcare is going," says Kathryn Sheeran, quality and research manager for The San Antonio Orthopaedic Group. "Doctors that were doing clinical trials said, 'Hey, this could be useful for all my patients, not just the ones in investigational studies.'"...