Inside the Accelerator: Understanding the Recovery Phase Through Patient-Reported Outcome Measures
What happens to older adult patients after they leave the hospital? For many, recovery continues in rehab or at home, where new challenges can emerge. For clinicians, that period has historically been difficult to capture.
The West Health Accelerator at Mass General Brigham is helping to shed light on older patients’ post-discharge experience by making their voices heard through patient-reported outcome measures (PROMs). “Over and over again, PROMs reveal insights that clinical teams and healthcare systems just didn't know about,” says Andrea L. Pusic, MD, MPH, FACS, FRCSC, medical director of the Mass General Brigham PROMs program and director of the Patient-Reported Outcomes, Value, and Experience (PROVE) Center. “This initiative excites me because it will give us a lens into the lived experience of older adults after they are discharged from the hospital, which will allow us to address problems we didn't know existed.”
Peter Meyers, the program’s administrative director, says that Mass General Brigham has been a leader in this space for years, having collected approximately 40 million questionnaires since the program started in 2013. “We are the largest patient-reported outcome measures program in the country,” he says. “It’s incredibly exciting to support care innovation and bring the voice of the patient into clinical care in such a broad and measurable way—through data that saves lives.”
Capturing the Recovery Experience of Older Adults
Pusic’s team worked closely with patients and clinicians to shape a short questionnaire, ensuring it reflects what matters most to patients. “We have some questions that are specific to the care that patients received, like their communication with their providers and whether they felt involved in the decision making,” explains Maria Orlando Edelen, PhD, a psychometric scientist with the PROVE Center and an expert on PROMs. “Other questions look at how patients are functioning at home and whether they’re able to participate socially the way that they want to.”
Pusic and Meyers’ team helped integrate the questionnaire into Epic. The questionnaire will be delivered to patients ages 65 and older through the Patient Gateway at key moments after discharge, with reminders via email and text. “I think this will give us a really unique window into what's going on when patients leave the hospital,” says Claire Morton, MD, a second-year MERITAS fellow with the PROVE Center. “Right now, it’s this big black box.”
Building a Scalable Model
The team is currently testing and validating the questionnaire, which is expected to launch this summer. Employing an implementation science approach, they will then study response rates, refine outreach, and continue improving how PROMs are used. “We’ll start small and then take those learnings and scale them,” says Edelen. But the long-term vision is much bigger. By embedding PROMs into Epic, the Accelerator is creating a model that could extend far beyond a single health system.
“Once this is operational, it can be added to the available library of PROMs content for all Epic customers,” says Meyers. “That will really extend our role at Mass General Brigham—reaching beyond our walls to help support patients globally.”
Edelen emphasizes the collaborative nature of the work and what it’s unlocking. “It's been great to collaborate with such an invested group,” she says. “We have a real opportunity to advance our understanding of how to ask this cohort of patients about their experience and to bridge the gap in continuity of care from acute care to outpatient care,” she says. “There's just so much potential.” Pusic adds, “Because it’s such a growing patient population, this is going to have a really significant impact.”