The next frontier in quality care measurement: How patients feel

When patients visit Dr. Judy Baumhauer in hopes of getting rid of bunions—a painful, bony bump that develops at the base of the big toe—they often have just one question: Will surgery help?

The answer varies from patient to patient, said Baumhauer, an orthopedic surgeon at the University of Rochester (N.Y.) Medical Center. A highly useful tool for determining the most effective treatment is a patient survey from Promis, or Patient-Reported Outcomes Measurement Information System, composed of questions about the patient’s quality of life and ability to function.

“I listen to their concerns about their bunion, we look at X-rays together, and then we look at their Promis scores,” said Baumhauer, who has researched the tool extensively and sits on the board of directors for the Promis Health Organization. If the Promis results show a patient is functioning well, then surgery is unlikely to help. That knowledge allows her to confidently tell a patient that nonsurgical treatment is the best option.

Physicians, policymakers and payers in healthcare are increasingly asking patients for their input. This information is viewed as vital for clinicians, payers and health systems as the industry transitions from fee-for-service to value-based payment. By shaping clinical decisions and helping gauge the benefit of medical care, the patient’s perception of health before and after treatment is critical not only for maximizing the quality of care but also for assessing its value, many in the industry say.

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