This Funding Opportunity Announcement (FOA) invites U18 cooperative agreement applications to stimulate innovative and collaborative research by utilizing new health information technology (IT) strategies for collecting and using patient-reported outcome (PRO) measures in primary care and other ambulatory care settings.
The patient’s perspective is central to healthcare decisions affecting prevention, diagnosis, treatment and long-term care. Patient-reported outcomes (PROs) offer a complementary perspective to that of clinician assessments, and may provide greater insights into health status, function, symptom burden, adherence, health behaviors, and quality of life. PROs can inform the clinical management of individuals, shared decision-making, patient self-management support, care planning, goal setting, and goal attainment. Furthermore, PROs provide important data for research and quality improvement efforts. For the purposes of this FOA, PROs are data provided by patients regarding their health and functional status, including quality of life, symptoms, and activities of daily living.
Several validated PRO measures are publically available and used to gather PRO data. For example, the National Institutes of Health (NIH) funded the development of the Patient Reported Outcomes Measurement Information System® (PROMIS) which contains instruments for many physical, mental, and social health domains. Electronic health record (EHR) systems in use today often do not collect PRO data in structured or standardized ways that can afford truly meaningful use for broad and comprehensive clinical or health outcomes measurement. While some EHR systems are currently able to capture some structured PRO data, including data from many of the NIH-funded PROMIS® instruments, such information is not commonly collected and integrated at the point of care. Thus, PRO data are not routinely available for clinical care, research, and quality improvement.
AHRQ is interested in studies that develop new health IT strategies for implementing existing PRO measures in ambulatory care environments, including studies that support the care of people with multiple chronic conditions (MCC). Although collection of PROs is advancing rapidly, and PROs have been widely used in research and select clinical settings, little is known about how to best use them in primary care and with the diverse populations served in ambulatory care settings, especially populations with MCC. Managing multiple chronic conditions can be very complicated partly because clinical care guidelines typically focus on single conditions without recognizing the potential contraindications or appropriate prioritization of treatments for multiple conditions. From the perspective of patients and their caregivers, the complexity and burden of recommended treatments may be so high that adherence is extremely challenging, even with robust cognitive and social resources. Implementing the use of PRO measures as part of standard care has the potential to improve MCC care by orienting clinicians and clinical teams to the outcomes that matter most to patients, thereby facilitating the prioritization and ultimate effectiveness of care.
Due to the expansion of consumer-oriented electronic platforms and technologies, the opportunity exists to develop new, patient-centered health IT strategies for effective PRO implementations. In general, there is a need to facilitate the collection and use of PROs in primary care and other ambulatory care contexts in a manner that is efficient, actionable, supports patients’ engagement with their health and care, and improves clinical processes and outcomes. Ultimately, these advances should improve patient-provider communication and decision-making in healthcare delivery as well as contribute to the increased availability of PRO data for quality improvement and research efforts.
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Filed Under: Funding Opportunities