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EGEMS (Wash DC). 2018 May 10;6(1):5. doi: 10.5334/egems.201.

Data Management for Applications of Patient Reported Outcomes.

Author information

Institute for Health Research, Kaiser Permanente Colorado, Denver, CO, US.
Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, US.
Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, US.
Meyers Primary Care Institute, a joint endeavor of the University of Massachusetts Medical School, Reliant Medical Group and Fallon Health, Worcester, MA, US.
Palo Alto Medical Foundation Research Institute, Palo Alto, CA, US.
Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, US.
Geriatric Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, US.
Kaiser Permanente Washington Health Research Institute, Seattle WA, US.
Division of Gerontology, Department of Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, US.
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, US.



Patient reported outcomes (PROs) are one means of systematically gathering meaningful subjective information for patient care, population health, and patient centered outcomes research. However, optimal data management for effective PRO applications is unclear.

Case description:

Delivery systems associated with the Health Care Systems Research Network (HCSRN) have implemented PRO data collection as part of the Medicare annual Health Risk Assessment (HRA). A questionnaire assessed data content, collection, storage, and extractability in HCSRN delivery systems.


Responses were received from 15 (83.3 percent) of 18 sites. The proportion of Medicare beneficiaries completing an HRA ranged from less than 10 to 42 percent. Most sites collected core HRA elements and 10 collected information on additional domains such as social support. Measures for core domains varied across sites. Data were collected at and prior to visits. Modes included paper, clinician entry, patient portals, and interactive voice response. Data were stored in the electronic health record (EHR) in scanned documents, free text, and discrete fields, and in summary databases.

Major themes:

PRO implementation requires effectively collecting, storing, extracting, and applying patient-reported data. Standardizing PRO measures and storing data in extractable formats can facilitate multi-site uses for PRO data, while access to individual PROs in the EHR may be sufficient for use at the point of care.


Collecting comparable PRO data elements, storing data in extractable fields, and collecting data from a higher proportion of eligible respondents represents an optimal approach to support multi-site applications of PRO information.


data collection; electronic health records; patient reported outcomes; patient-centered care

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