OBJECTIVES: PROMoting Quality investigates the potential of integrating the patient perspective via digital Patient-Reported Outcome Measures (PROMs) into the patient pathway after knee and hip replacements. Early detection of adverse recovery pathways are expected to yield cost-efficient improvements of care quality. As an initiative of the government funded “Innovationsfonds”, the goal of the study is to transfer the study design into German standard care.

METHODS: PROMoting Quality is a two-arm multicenter randomized controlled trial. Patients from nine German hospitals are digitally accompanied from hospital admission to 12 months after discharge by regular PROM questionnaires (e.g., EQ-5D-5L, HOOS-PS, KOOS-PS). Algorithm-based thresholds alert study assistants, should patients not recover in line with expected recovery. The study assistants contact patients and their physicians to investigate and, if needed, adjust the post-treatment protocol [1]. Two major insurers will provide claims data at patient level to evaluate cost-effectiveness.

PRELIMINARY RESULTS: Patient enrollment was completed in December 2020 with a sample size of >8,000. To date, patients have provided 9,000 responses to follow-up questionnaires (1, 3, and 6 months post-discharge), resulting in a return rate of 85%. Depending on follow-up month, 15 - 30% of patients in the intervention group have triggered alerts. Concurrently 30% of patients have engaged in conversations regarding their PROMs with their post-treatment physicians. Additionally, surveys among study assistants report time-saving and robust digital workflows with high acceptance rates of PROM-based interventions among physicians involved.

CONCLUSIONS: The study allows participating hospitals and insurers to delve deeper into the systematic collection of PROMs in line with the principles of value-based healthcare. Preliminary results based on excellent patient engagement rates indicate that PROMoting Quality can set a blueprint for using PROMs as an intervention and quality measurement tool in standard care. [1] Kuklinski et al. (2020) https://doi.org/10.1186/s13063-020-04252-y