Efficacy of Automated Online PRO’s
Background: Recent validations studies support the use of outcome measures on home computers, mobile tablet devices, and email. This study expanded upon a prior pilot study validating the use of email-based automated outcome measures. We integrated a cloud-based automated collection system into four hand surgery practices for 52-weeks and hypothesized that clinical integration of this system in different environments would be efficient and cost effective.
Methodology: This prospective, multi-center study evaluated the efficacy of automated, email-based notifications to complete an online QuickDASH (QDASH) questionnaire. Pre-operative patients for eight hand surgeons at four centers participated in the study. All patients completed a QDASH questionnaire on a tablet device immediately pre-operatively and, if agreeable to the study, received follow-up email requests at 3-, 6-, 12-, 24-, and 52-weeks post-operatively. Outcomes are reported as descriptive statistics summarizing the efficacy of automated data collection.
Results: A total of 2,046 patients were enrolled in the study and 2,374 QDASH scores were recorded during an 18-month enrollment and study period. In total, 56.3% patients with email completed at least one outcome assessment and 14.2% completed all five assessments (Figure 1). The response rates at each time point trended downward, with a rate of 45.3% at 3 weeks, trending down to 28.8% at 52 weeks (Figure 2). All QDASH surveys were administered, scored, and analyzed without any human intervention, resulting in an estimated time and cost savings of 340+ medical assistant working hours.
Conclusion: Emailed-based outcome questionnaires are successful and cost effective for collecting post-operative patient reported outcomes. Response rates vary from 28-45% for a given time point and over half of patients respond to at least one survey request.