While health care evolves from volume to value, there is increasing interest by payors to use patient-reported outcomes (PROs) to determine value and more specifically, quality from the patient's perspective. This article reviews the current state of PROs and discusses future directions. Specifically, this article will review the current history and background of PROs; it will highlight the perspective of the National Quality Forum and review the efforts of the musculoskeletal community related to PROs. Goals, positive aspects, limitations, and barriers related to PROs will be discussed. Additionally, development considerations and strategies will be highlighted. Finally, development recommendations from the American Academy of Orthopaedic Surgery position statement “principles for musculoskeletal based PRO performance measurement development” will be introduced.
From Northland Orthopaedics, Rhinelander, WI (Dr. Lowry), Kaiser Permanente Fresno Medical Center, Fresno, CA (Dr. Brox), the American Academy of Orthopaedic Surgeons, Rosemont, IL (Dr. Naas), New Braunfels Orthopaedic Surgery & Sports Medicine, New Braunfels, TX (Dr. Tubb), the Cleveland Clinic, Cleveland, OH (Dr. Muschler), and the School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI (Dr. Dunn).
Dr. Lowry or an immediate family member serves as a paid consultant to Security Health Plan and serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, ASTM, and AMA—PQPI. Dr. Naas an immediate family member serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons, American Society of Anesthesiologists, Steering Committee, Perioperative Surgical Home Collaborative, University of Minnesota Department of Orthopaedic Surgery, Liaison, Orthopaedic Surgeon Well-being Project. Dr. Tubb or an immediate family member serves as a board member, owner, officer, or committee member of the American Academy of Orthopaedic Surgeons and American Association of Hip and Knee Surgeons. Dr. Muschler or an immediate family member has received royalties from Fortus; serves as a paid consultant to the National Institutes of Health; serves as an unpaid consultant to Parker Hannifin; and has received research or institutional support from Fortus. Neither of the following authors nor any immediate family member has received anything of value from or has stock or stock options held in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Brox and Dr. Dunn.