ArticleApplied clinical informatics2024
Seamless Integration of Computer-Adaptive Patient Reported Outcomes into an Electronic Health Record.
Article in Applied clinical informatics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 9 citations in OpenAlex.
- Longitudinal Evaluation of the HABC Monitor Among Trauma Survivors.Clinical interventions in aging · 2025Trial
- Symptom Tracking for Patient-Reported Outcomes in Cancer: User-Centered Design of the AthenaCompanion Web Application.Journal of medical Internet research · 2026Article
- Using confirmatory factor analysis to identify symptom clusters in individuals with acquired disabilities.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Designing an Electronic Patient-Reported Outcomes Information Infrastructure Supported by the RE-AIM Implementation Framework.Advances in cancer education and quality improvement · 2025Article
- A Surgeon's Field Guide to Value-Based Specialty Care.Laryngoscope investigative otolaryngology · 2025Review
- Patient-Reported Outcomes Program at Scale at a Cancer Center.JCO clinical cancer informatics · 2025Article
- Validation of PROMIS anxiety item bank computer adaptive test among patients with heart failure.Frontiers in cardiovascular medicine · 2025Article
- Predictors of Concordance between Patient-Reported and Provider-Documented Symptoms in the Context of Cancer and Multimorbidity.Applied clinical informatics · 2024Article
- Article
- Selecting patient-reported outcome measures: "what" and "for whom".Health affairs scholar · 2024Article
- Enhancing Measurement Precision of Patient-Reported Outcomes Using Item Response Theory.Inquiry : a journal of medical care organization, provision and financingArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundPatient-reported outcome (PRO) measures have become an essential component of quality measurement, quality improvement, and capturing the voice of the patient in clinical care. In 2004, the National Institutes of Health endorsed the importance of PROs by initiating the Patient-Reported Outcomes Measurement Information System (PROMIS), which leverages computer-adaptive tests (CATs) to reduce patient burden while maintaining measurement precision. Historically, PROMIS CATs have been used in a large number of research studies outside the electronic health record (EHR), but growing demand for clinical use of PROs requires creative information technology solutions for integration into the EHR.
objectivesThis paper describes the introduction of PROMIS CATs into the Epic Systems EHR at a large academic medical center using a tight integration; we describe the process of creating a secure, automatic connection between the application programming interface (API) which scores and selects CAT items and Epic.
methodsThe overarching strategy was to make CATs appear indistinguishable from conventional measures to clinical users, patients, and the EHR software itself. We implemented CATs in Epic without compromising patient data security by creating custom middleware software within the organization's existing middleware framework. This software communicated between the Assessment Center API for item selection and scoring and Epic for item presentation and results. The middleware software seamlessly administered CATs alongside fixed-length, conventional PROs while maintaining the display characteristics and functions of other Epic measures, including automatic display of PROMIS scores in the patient's chart. Pilot implementation revealed differing workflows for clinicians using the software.
resultsThe middleware software was adopted in 27 clinics across the hospital system. In the first 2 years of hospital-wide implementation, 793 providers collected 70,446 PROs from patients using this system.
conclusionThis project demonstrated the importance of regular communication across interdisciplinary teams in the design and development of clinical software. It also demonstrated that implementation relies on buy-in from clinical partners as they integrate new tools into their existing clinical workflow.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.