Implementing PROMs

Learnings from those who have implemented PROMs. 

The scale of implementation can range from an individual clinician introducing PROMs into practice to international efforts, such as the work of the Organisation for Economic Co-operation and Development (OECD) and the International Consortium for Health Outcomes Measurement (ICHOM).

There is insufficient evidence to inform a best practice approach to implementation. While there is no single best approach, those who have implemented PROMs have highlighted several key considerations.

Implementation considerations

Successful implementation approaches are likely to be context driven and will vary considerably between initiatives. The starting point for initiatives will be to decide the purpose of implementing PROMs. Clarifying the purpose will have a direct bearing on subsequent choices, such as what PROMs to use, what resources will be made available to support their use, and whether patient responses will be processed in a timely manner for clinical consultations. Full engagement with stakeholders will be necessary to negotiate compromises.

In stakeholder interviews conducted for the Commission, various implementation considerations were mentioned, including:

  • Ownership of initiative
  • Appropriate change management strategy
  • Co-design and collaboration principles
  • Patient engagement/participation
  • Selecting PROMs
  • Resourcing
  • Training and education
  • Participation support and incentives
  • Sufficient time for implementation
  • Piloting and phased implementation
  • Embedding in regular practice
  • Regular feedback
  • Demonstrable benefits
  • Implementation review processes
  • Reviewing PROMs periodically.