title: Feasibility of a Tablet Computer System to Collect Patient-reported Symptom Severity in Patients Undergoing Diagnostic Coronary Angiography.
abstract: BACKGROUND
  Percutaneous coronary intervention is the most commonly performed revascularization modality for chronic stable angina, but does not improve survival or reduce major adverse cardiovascular event. Percutaneous coronary intervention in this population is performed primarily for symptomatic benefit; therefore, symptom reduction is an important marker of quality. Patient-reported outcome measures (PROMs) have been developed for chest pain and dyspnea which are valid and responsive to treatment; however, they are not widely used in routine care. We present a model for use of PROMs in routine care.
  
  
  METHODS
  Partners Health System funded a tablet computer software platform to collect PROMs and include them in the medical record. We implemented this platform in the catheterization laboratory at Massachusetts General Hospital, targeting patients presenting for coronary angiography. Patients are assessed using the SAQ-7, the Rose dyspnea scale, the PHQ-2, and the PROMIS-10. We used a phased implementation, with the final program including preprocedure measurement, presentation of data to clinical providers, and follow up using an email platform.
  
  
  RESULTS
  We successfully captured measures from 474 patients, 53.5% of outpatient visits. Key success factors included high-level leadership support and resources, a user-friendly interface for patients and staff, easily interpretable measures, and clinical relevance.
  
  
  CONCLUSIONS
  We have demonstrated that routine capture of patient-reported symptom severity is technically feasible in a real-world care environment. We share our experiences to provide others with a model for similar programs, and to accelerate implementation nationwide by helping others avoid pitfalls. We believe expansion of similar programs nationally may lead to more robust quality infrastructure.
authors.affiliation: From the *Massachusetts General Hospital, Edward P. Lawrence Center for Quality and Safety, Boston, MA; †University of Rochester Medical Center, Division of Cardiovascular Disease, Rochester, NY; ‡Brigham and Women's Hospital, Division of General Medicine and Primary Care, Boston, MA; §Harvard Medical School; ‖Partners Healthcare System, Boston, MA; and ¶Massachusetts General Hospital, Corrigan-Minehan Heart Center, Boston, MA.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Bruckel
authors.forename: Neil
authors.initials: N
authors.lastname: Wagle
authors.forename: Cashel
authors.initials: C
authors.lastname: O'Brien
authors.forename: Josephine
authors.initials: J
authors.lastname: Elias
authors.forename: Sharon
authors.initials: S
authors.lastname: McKenna
authors.forename: Peter
authors.initials: P
authors.lastname: Meyers
authors.forename: Michael A
authors.initials: MA
authors.lastname: Fifer
authors.forename: Eugene
authors.initials: E
authors.lastname: Pomerantsev
authors.forename: Robert W
authors.initials: RW
authors.lastname: Yeh
mesh_terms: D060050:Angina, Stable / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D002637:Chest Pain / Q000175:diagnosis* / Q000209:etiology; D034201:Computers, Handheld; D017023:Coronary Angiography; D003625:Data Collection; D004417:Dyspnea / Q000175:diagnosis* / Q000209:etiology; D005240:Feasibility Studies; D006304:Health Status; D006801:Humans; D063868:Patient Outcome Assessment; D062645:Percutaneous Coronary Intervention; D012720:Severity of Illness Index; D012984:Software