Patient Reported Outcomes Via Electronic Survey (PROVES): A Pilot Study in a Breast Surgery Clinic

Introduction: Patient reported outcomes (PROs) have been correlated with health outcomes and are increasingly recognized in value-based care. However, measurement and documentation of PROs have not been standardized in surgical settings. Methods: A pilot study implementing electronic PRO capture into an electronic medical record (EMR) was performed in an outpatient breast surgery clinic setting. Between 6/28/19 and 2/7/20, new breast clinic patients were invited to complete the RAND 36-Item Short Form Health Survey (SF-36) via patient portal during electronic check-in or upon arrival using a HIPAA-compliant touch screen tablet interface. Survey results were automatically populated into the patients’ clinic encounters. Results: Of 136 new patients (median age 50 years [range 15-94]), 134 (98.5%) were women and had diagnoses of malignancy in 35 (25.0%), mastodynia in 9 (6.6%), and high risk in 5 (3.7%). Surveys were initiated in 97 (72.4%), of which 77 (79.4%) were via patient portal and 20 (20.6%) were by tablet in clinic. Overall, 68 (70.1%) of initiated surveys were completed. Patients with cancer had lower physical functioning scores compared with those without (61.8±33.6 vs 80.2±26.9, p=0.01), but scored similarly in all other domains. Patients with mastodynia scored significantly lower in general health (32.5±9.6 vs 66.7±22.2, p=0.003), physical functioning (38.8±38.2 vs 77.7±28.0, p=0.009), social functioning (59.4±31.3 vs 81.3±21.6, p=0.06), and pain (30.6±24.4 vs 75.6±24.7, p=0.0006) than those without mastodynia (Table). Conclusion: Electronic capture of PROs is technically feasible in an outpatient breast surgery clinic setting and has diagnostic discriminatory potential. Further study is required to correlate real time PROs with outcomes. [Formula presented]