Special Section on Patient Engagement in Informatics: A RE-AIM evaluation of a visualization-based electronic patient-reported outcomes system.
Academic Article
Overview
abstract
INTRODUCTION AND OBJECTIVE: Healthcare systems are primarily collecting patient-reported outcomes (PROs) for research and clinical care using proprietary, institution- and disease-specific tools for remote assessment. The purpose of this study was to conduct a Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM) evaluation of a scalable electronic patient reported outcomes (ePROs) reporting and visualization system in a single-arm study. METHODS: The "mi.symptoms" ePRO system was designed using gerontechnological design principles to ensure high usability among older adults. The system enables longitudinal reporting of disease-agnostic ePROs and includes patient-facing PRO visualizations. We conducted an evaluation of the implementation of the system guided by the RE-AIM framework. Quantitative data were analyzed using basic descriptive statistics, and qualitative data were analyzed using directed content analysis. RESULTS: Reach-The total reach of the study was 70 participants (median age 69, 31% female, 17% Black or African American, 27% reported not having enough financial resources). Effectiveness-Half (51%) of participants completed the two-week follow-up survey and 36% completed all follow-up surveys. Adoption- The desire for increased self-knowledge, the value of tracking symptoms, and altruism motivated participants to adopt the tool. Implementation-The predisposing factor was access to, and comfort with, computers. Three enabling factors were incorporation into routines, multimodal nudges, and ease of use. Maintenance-Reinforcing factors were perceived usefulness of viewing symptom reports with the tool, and understanding the value of sustained symptom tracking in general. CONCLUSION: Challenges in ePRO reporting, particularly sustained patient engagement, remain. Nonetheless, freely available, scalable, disease-agnostic systems may pave the road towards inclusion of a more diverse range of health systems and patients in ePRO collection and use.
