NQF Releases a Roadmap Providing Guidance on Developing Digital Patient-Reported Outcome Performance Measures 

Washington, DC – In response to the expressed need for additional guidance in developing high impact patient-reported outcome performance measures (PRO-PMs), National Quality Forum (NQF) has published a Technical Guidance Report.

Elevating the patient voice through patient-reported outcomes (PROs) is critical to achieving equity, strengthening the care experience, and improving health outcomes for all. PROs represent the measurement of a patient’s health directly from the patient – asking about dimensions of care that are best assessed by asking patients directly (e.g., pain, functional limitations, energy, emotional distress). Patient-reported outcome measures (PROMs) represent the tools and instruments that are used to collect the data (e.g., the Patient Health Questionnaire 9 [PHQ-9]). PROMs can be used to collect data over time, thereby measuring changes that are occurring for patients and populations. These longitudinal uses of PROMs can form the basis for performance measures (PRO-PMs), where the information is used to hold providers and payers accountable for the outcomes they achieve for their populations.

“Value-based quality programs implemented by CMS and other payers need rigorously developed quality measures that use the voice of the patient to evaluate care outcomes, and PRO-PMs are an ideal but underutilized tool to accomplish this goal. NQF’s report distills the knowledge and expertise from a broad range of PRO-PM stakeholders and experts to provide a set of best practices to facilitate organizations’ ability to develop and implement high quality digital PRO-PMs,” said Committee Co-Chair Dr. Sam Simon, Director of Health Program Improvement at Mathematica.

This report will aid measure developers in developing digital PRO-PMs that are fully tested and ready for submission to the NQF endorsement process. PRO-PMs require using PROMs as the tool to measure how a patient's health is changing over time. It uses a PROM and implements it in a standardized cadence (e.g., every 3 months or before and 6 months after a procedure) to enable measurement of how the patient is responding to a treatment. At the population level, the information can demonstrate how groups of patients respond to a treatment, ultimately helping build evidence about what works and what doesn't and, most importantly, for whom.

“Patient-reported information about health status—such as pain, physical mobility, emotional well-being, energy and fatigue—has been routinely used in clinical trials to test the impact of medication and other treatments on improving patient health. These types of measures are only now beginning to be utilized in clinical care and considered for use in performance measurement. In order to incorporate PROMs into routine practice, it is important to shift to digital data collection so these methods are being developed for scaled use,” said Dana Gelb Safran, ScD, NQF President and Chief Executive Officer.

This is the third and final report from the first year of NQF’s Building a Roadmap From Patient-Reported Outcome Measures (PROMs) to Patient-Reported Outcome Performance Measures initiative. It builds on two previous reports from this initiative: an Environmental Scan Report describing the current state of using PROMs as the data collection instruments for performance measures, and an Interim Report for identifying the attributes of high quality PROMs for use in digital PRO-PMs. The Technical Guidance Report serves as a companion to use alongside other resources such as the Centers for Medicare & Medicaid Services (CMS) Measures Management System Blueprint, NQF’s Measure Developer Guidebook, and NQF’s Measure Evaluation Criteria.

This initiative was funded and driven by CMS, who has partnered with NQF for more than a decade in advancing patient-reported outcome quality measurement. The broad experience of the Technical Expert Panel, convened by NQF at the direction of CMS, helped to ensure diverse viewpoints were considered throughout the report development process. The perspectives of the TEP included measure developers, patients, patient advocacy groups, health IT professionals, clinicians, health systems, payers, purchasers, and researchers. 

About National Quality Forum
The National Quality Forum (NQF) works with members of the healthcare community to drive measurable health improvements together. NQF is a not-for-profit, membership-based organization that gives all healthcare stakeholders a voice in advancing quality measures and improvement strategies that lead to better outcomes and greater value. Learn more at www.qualityforum.org.