What are patient-reported measures (PRMs)?
Patient-reported measures (PRMs) capture information via surveys, which ask patients about their healthcare experiences and the outcomes of their care.
Patient-reported measures can be grouped into the following two categories:
Patient reported experience measures (PREMs)
PREMs capture the patient's perception of their experience with healthcare or services
Patient reported outcome measures (PROMs)
PROMs capture the patient's perspectives about how illness or care impacts on their health and wellbeing
Why use PRMs?
With today’s technological advancements, there is a lot we can tell about a patient without even talking to them (e.g. their heart rate and blood pressure, and recent admission history). However, unless patients (and/or their carers) are asked about what is important to them and how they rate their quality of life and experiences of healthcare, we don’t know the whole picture.
The evidence demonstrates that clinical indicators often fail to correspond with how a patient is feeling. Therefore, it is important to routinely ask for the patient's perceptions of their own health and wellbeing, at the point of care.
This can be achieved through the systematic collection and use of patient-reported measures (PRMs). There is good evidence to demonstrate that patients who are more engaged in their healthcare tend to choose less costly interventions (e.g. presenting to a physiotherapist for lower back pain instead of hospital emergency).
PRMs have also been well documented to support clinician decision-making and shared care planning. They are a good indicator for overall patient outcomes; especially in those conditions marked by a person’s level of health and wellbeing, rather than their risk of dying.
To achieve improvements in clinical care and service delivery, PRMs must be:
- reliable, valid and sensitive to detect change
- relevant and meaningful to patients and clinicians
- not duplicating work or be overly burdensome
- inclusive (by aiming for high response rates across the target population to include people with complex needs)
- acted upon – meaning that PRMs data is used collaboratively by the care team at the various levels (patient, service and system) to improve and integrate care
- relevant to all populations, including priority populations.
What is the PRMs Program?
The statewide Patient Reported Measures (PRMs) Program uses patient feedback across all levels of the health system to drive improvements in care.
This video provides information about the PRMs Program, including:
- what is the PRMs Program
- who is participating in the program
- how can patient-reported measures be used in a clinical consultation
- why is it important (i.e. the benefits of patient-reported measures, from a patient and clinician viewpoint)?
Duration: 10min, 14sec
Aboriginal health and patient-reported measures
The PRMs program has been co-designed to support the culturally-appropriate and culturally-safe design, implementation, collection and use of PRMs.
In December 2019, the ACI established a Patient Reported Measures Aboriginal Health Working Group.
The purpose of the PRMs Aboriginal Health Working Group is to assess the cultural validity of the current patient-reported outcome measures (PROM) tools for Aboriginal populations across the state, with specific reference to the health-related quality of life (QoL) tool.
The QoL measures must be meaningful, culturally relevant, validated and fit-for-purpose for Aboriginal and non-Aboriginal people.
The working group will support and guide a trial of the identified QoL PROM/s within Aboriginal communities and evaluate their effectiveness.
This work will support the routine and systematic collection of PRMs across NSW in a culturally-appropriate way.
PRMs are short for Patient Reported Measures.
Patient Reported Measures or PRMs are questions that you will be asked to answer before or after seeing a doctor or nurse. There are two types of PRMs questions. They look like a normal survey. The first type is Patient Reported Outcome Measures or PROMs. The second type is Patient Reported Experience Measures or PREMs.
Learning about your outcomes and experiences helps the doctors and nurses understand what matters to us and our mob, help them to make sure they know what we want and also look at what is working well or what is not working.
Patient Reported Outcome Measures or PROMs.
PROM questions ask you about how you are feeling today and the doctor or nurses will read what you have said and talk to you about how they can help. Learning about your outcomes helps the doctors and nurses understand what’s happening in your life, what things are not so good and what things are going ok. They can use your answers to look at how to make it better for you and family. It allows you to tell them how it is and what matters to you. You will be asked questions like do you have any pain, how easy is it to get around, are you sleeping well and do you feel low. They can use your answers to talk through what you would like from them, what is important and work together to make things right.
Patient Reported Experience Measures or PREMs.
PREM questions ask you about your experience, the doctors and nurses want to hear about how you feel after receiving care from them. They also want to hear if you feel culturally safe and have a good relationship with the person helping you. When you answer the PREM questions no one knows what you have said cos your name is not recorded so you can really tell them the truth.
Learning about your experiences helps the doctors and nurses understand what’s deadly about their care and their service. They can use your answers to look at how to make it better for you and our mob. You will be asked questions like did you understand, did they include family, do they realize the importance of family, do you trust them. They can use your answers to look at what is working well or what is not working.
Communicating about PRMs in a culturally-appropriate way
The PRMs Aboriginal Health Working Group commissioned Aboriginal artist Denis Golding to produce an artwork that references patrient-reported measures through indigenous cultural symbolism and creative practices of innovation.
Circular objects referencing camping grounds, meeting places and sites which are connected through lined patterns are used to represent pathways or river systems. Included within these images are boomerangs which a strong representation of cultural practice and technologies of weapons for hunting and throwing. These are innovative practices, which continue to share knowledge, skills and experiences which echo the same practices of PRMs to heighten Indigenous stories and contemporary experiences.
This artwork will be uploaded on to iPad devices and displayed at proof-of-concept sites.
Would you like to be involved in the PRMs Aboriginal Health Working Group? Contact us at ACI-PRM@health.nsw.gov.au.