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Using Patient-Reported Outcomes in Routine Practice

Three Novel Use Cases and Implications

Forsberg, Helena Hvitfeldt PhD; Nelson, Eugene C. DSc, MPH; Reid, Robert MD, PhD, MPH; Grossman, David MD, MPH; Mastanduno, Melanie P. MPH, RN; Weiss, Lisa Torrey MBA; Fisher, Elliott S. MD, MPH; Weinstein, James N. DO, MS

The Journal of Ambulatory Care Management: April/June 2015 - Volume 38 - Issue 2 - p 188–195
doi: 10.1097/JAC.0000000000000052
Original Articles

Patient-reported outcomes (PROs) can show how patients perceive their illness burden over time. Active use of PROs by clinicians at the point of service can help illuminate the patients' longitudinal changes in outcomes, thereby advancing shared decision making, patient engagement, and self-care. This article offers principles and lessons learned from using PROs and provides 3 case studies to demonstrate how to overcome the challenges in using PROs in routine clinical practice to improve outcomes. These cases demonstrate that it is possible to embed patient-generated data into the flow of care and to track outcomes for improvement and research.

Department of Learning Informatics Management and Ethics and Medical Management Center, Karolinska Institutet, Stockholm, Sweden (Dr Forsberg); The Dartmouth Institute for Health Policy and Clinical Practice and the Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire (Drs Nelson, Fisher, and Weinstein and Mss Mastanduno and Weiss); and Group Health Research Institute, Seattle, Washington (Drs Reid and Grossman).

Correspondence: Eugene C. Nelson, DSc, MPH, Dartmouth-Hitchcock Medical Center, 35 Centerra Pkwy, Ste 300, Lebanon, NH 03766 (

The authors thank Susan Edgman-Levitan, PA, from the John D. Stoeckle Center for Primary Care Innovation at Massachusetts General Hospital, and Nancy Wilson, MD, from the Agency for Healthcare Research and Quality, for serving as external reviewers and for their guidance, suggestions, and critique of this article. The authors also are grateful for the generous financial support given to the Population Health Center at The Dartmouth Institute by The Dartmouth Center for Healthcare Delivery Science to advance the science of patient-reported measures of health outcomes, patient experience, and decision quality.

There are no conflicts of interest for the authors or their organizations. Partial Funding for Dartmouth authors Dr Nelson and Ms Mastanduno was provided by the Dartmouth Center for Healthcare Delivery Science.

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