Washington [US]: According to a new evaluation published in the Journal of the Royal Society of Medicine, digital systems for patients to monitor and report symptoms remotely may offer a way to minimize Outpatient waiting lines.
The review, led by researchers from the Patient Reported Outcomes Research Center (CPROR), Institute of Applied Health Research at the University of Birmingham, reviewed international examples of the use of patient-reported electronic result (ePRO) for clinical care triage.
ePROs allow patients to complete questionnaires at home or at a location of their choice, with the results sent to the physician in near real time for use in clinical decision-making. Studies of various patient groups were included in the review, including those with epilepsy, sleep apnea, type 1 diabetes, cancer, rheumatoid arthritis, and HIV. In Denmark, Ambuflex, a generic ePRO system, has been used in more than 40,000 patients with a variety of chronic conditions and has led to substantial reductions in outpatient appointments. In epilepsy clinics, the system generated reductions of up to 48% in face-to-face outpatient visits.
Lead author Dr. Lee Aiyegbusi, Associate Professor and Deputy Director of CPROR, said: “The use of PRO is well established in research settings to assess the effectiveness, cost-effectiveness, and tolerability of interventions from the patient’s perspective. Clinicians are now interested in using patient-level symptom reporting for clinical management of individual patients in routine practice.”
The review provides evidence to support the implementation of ePRO systems for outpatient care, including significant reductions in outpatient appointments without compromising patient outcomes or satisfaction with care.
Dr Aiyegbusi said: “ePROs for outpatient care could make it easier to tailor care to patient needs. Stable patients can be remotely monitored using ePRO, thus avoiding unnecessary checkups in outpatient clinics and the associated costs, such as travel and leisure time, without reducing the quality of treatment. This efficient use of scarce healthcare resources could free up outpatient clinics for patients with a high symptom burden or concerning symptoms, so they can be seen more quickly.”
The authors say it is important to recognize that a proportion of patients, especially the elderly, may prefer face-to-face or telephone outpatient consultations regardless of their health status and may be concerned or reluctant to use ePRO as a triage tool. .
They also say the findings demonstrate why it is crucial that the use of ePRO for ambulatory care is carefully considered, planned and implemented to ensure that people in underserved populations are not further disadvantaged.
They concluded: “The use of ePRO in ambulatory care could potentially enable a more responsive healthcare system, reduce demand for clinic appointments, reduce time to care with better associated outcomes, and improve the cost effectiveness of healthcare delivery, all which is beneficial for patients, their families and society.”
