Feasibility of the collection of patient-reported outcomes in an ambulatory neurology clinic.
OBJECTIVE
To determine whether patients could self-report physical and mental health assessments in the waiting room and whether these assessments would be associated with modified Rankin Scale (mRS) and Quality of Life in Epilepsy (QOLIE-10) scores.


METHODS
We offered iPad-based surveys to consecutive adult neurology patients at check-in to collect patient-reported outcome measures (PROMs). We collected demographic and clinical data on 6,075 patients through survey or administrative claims and PROMs from participating patients. We compared demographic characteristics of participants and nonparticipants and tested associations between physical and mental health scores and mRS and QOLIE-10.


RESULTS
Of 6,075 patients seen by neurologists during the study period, 2,992 (49.3%) participated in the survey. Compared to nonparticipating patients, participating patients more often were privately insured (53.5% vs 42.7%, p < 0.01), married (51.5% vs 47.9%, p < 0.01), and seen in general neurology (nonsubspecialty) clinics (53.1% vs 46.6%, p < 0.01) and more likely to report English as their preferred language (50.1% vs 38.4%, p < 0.01). Participating patients had a mean physical health T score of 28.7 (SD 15) and mental health T score of 33 (SD 15), which were 3 and 2 SD worse than the average for the US general population, respectively. Mean T scores in every category of the mRS were different from every other category (n = 232, p < 0.01). Patient Reported Outcomes Measurement Information System-10 T scores were linearly associated with QOLIE-10 scores (n = 202, p < 0.01) CONCLUSIONS: Systematic digital collection of PROMs is feasible. Differences among survey participants and nonparticipants highlight the need to develop multilingual measurement tools that may improve collection from vulnerable populations.
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston. lidia.moura@mgh.harvard.edu.
Lidia M V R
LM
Moura
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
Eli
E
Schwamm
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
Valdery
V
Moura Junior
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
Michael P
MP
Seitz
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
John
J
Hsu
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
Andrew J
AJ
Cole
From the Department of Neurology (L.M.V.R.M., E.S., V.M.J., M.P.S., A.J.C., L.H.S.) and Mongan Institute for Health Policy (J.H.), Massachusetts General Hospital, Boston.
Lee H
LH
Schwamm
D000554:Ambulatory Care Facilities; D034201:Computers, Handheld; D005240:Feasibility Studies; D005260:Female; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000628:therapy*; D009462:Neurology / Q000379:methods; D000071066:Patient Reported Outcome Measures; D019727:Proxy; D058996:Quality Improvement; D011788:Quality of Life; D012189:Retrospective Studies; D057566:Self Report; D012959:Socioeconomic Factors