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Nicole De Guia



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    OS01 - It's All About the Patient Outcomes! (ID 1)

    • Event: e-Health 2019 Virtual Meeting
    • Type: Oral Session
    • Track: Clinical Delivery
    • Presentations: 1
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      OS01.03 - Patient-Reported Outcomes for Hip and Knee Replacements in Ontario (ID 430)

      Nicole De Guia, Patient-Reported Outcome Measures, Canadian Institute for Health Information; Toronto/CA

      • Abstract
      • Slides

      Purpose/Objectives:
      Patient-reported outcome measures (PROMs) are essential to patient-centred health care delivery. Hip and knee replacements are procedures aimed at improving patients? pain, functioning and overall quality of life. To support the delivery of patient-centred, evidence-based care, the Ontario Ministry of Health and Long-Term Care (MOHLTC) approached the Canadian Institute for Health Information (CIHI) and CCO to help execute a new PROMs project for hip and knee replacement patients. The PROMs project is being implemented in alignment with the bundled hip and knee replacement surgery Quality Based Procedure (QBP) program. Goals of the project included: ? Piloting collection of PROMs, with intent to scale-up to province-wide. ? Leveraging technology to support implementation and real-time reporting back to providers. ? Developing initial comparative reports for health system monitoring. ? Improving communications between providers and patients, informing treatment decisions and patient expectations. ? Complementing traditional, clinical outcomes, cost, and patient experience data for a more comprehensive understanding of their relationships. ? Supporting the evaluation of performance and effectiveness of care.


      Methodology/Approach:
      The MOHLTC oversees the governance structure for the project and provides leadership to ensure project alignment with the bundled hip and knee QBP project. The MOHLTC, CIHI and CCO have complementary roles in the execution of the PROMs project. CIHI is responsible for confirming data collection standards including instruments, minimum data set, and collection time points. After receiving PROMs data collected by CCO, CIHI will provide a range of comparative reports to support Ontario health system performance monitoring and evaluation (e.g., comparative reports to facilities and others, and data files to the MOHLTC). CCO has over a decade of experience overseeing the systematic collection of oncology PROMs in Ontario. Electronic PROMs collection is currently available at more than 80 oncology centres across the province and more than 30,000 oncology patient screens are completed via CCO?s e-PROMs platform each month. CCO has been commissioned to leverage and apply this expertise to the collection of hip and knee PROMs. CCO is responsible for implementing electronic PROMs collection across the province and for hospital-level data collection. CCO will regularly submit datasets to CIHI for use in comparative reporting. Based on the needs of the MOHLTC, the planned approach is a three-year pilot project which started September 1, 2017, with data collection commencing April 2018.


      Finding/Results:
      The objectives of the project are to demonstrate the value of collecting PROMs data, test the platform/mechanism for collecting PROMs data in Ontario, and initiate technological and business processes for a cost-effective scale-up to provincial implementation. Other benefits include measures of access and appropriateness, and the potential to support patient and surgeon decision-making prior to surgery. The goal of the pilot is to determine the most effective, user-friendly, and cost-effective method for collecting PROMs over the long-term.


      Conclusion/Implications/Recommendations:
      Ontario is the first province in Canada to implement the national PROMs hip and knee arthroplasty standards and electronic collection. Early learnings from an implementation, data and reporting perspective will be presented at the conference.


      140 Character Summary:
      To support patient-centred, evidence based care, a new patient-reported outcome measures project for hip and knee replacements has launched in Ontario.

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