Patient Reported Outcomes
Patient Reported Outcomes (PROs) are outcome measures that are directly reported by the patient to help better understand a treatment's efficacy. PROs have been used at many facilities to assist surgeons in evaluating their practices. The ABOS will begin using PROs as another tool to assist in the certification and recertification processes. Collecting PROs will also contribute to a surgeon’s continual practice improvement.
Starting with the 2018 Part II Oral Examination, Candidates will be required, for surgeries performed during the months of May and June 2017 for patients ages 12 and older, to enter each patient’s email address into the ABOS Scribe Case List System. The ABOS will then contact the patient, via email, pre- (or peri-) operatively as well as at six and 12 months post-operatively. The email will link the patient to a PROMIS Physical Function survey. 2018 Part II Candidates can get more detailed information on PROs and how they enter the information, by logging into their password protected portal and clicking on the Part II tab.
Frequently Asked Questions
How will the ABOS use the patient’s email address?
The ABOS will send an automated email to the patients based on the email addresses they provided with a link to the PROMIS Physical Function (PRO) assessment pre-/peri-operatively (at the time surgery is scheduled), at 6 and 12 months post-operatively. Patients will be sent a reminder email if they do not respond. The email addresses will be kept confidential and will not be used for any purpose other than this ABOS activity. The information collected will only be made available to the ABOS and the candidate.
How will the ABOS use this PRO data?
This PRO information will be reviewed, along with all content in the application, from peer review, and the case list by the ABOS to determine a candidate’s eligibility to sit for the Part II Oral Examination. The candidate will also receive PROs survey results obtained from his/her patients to assist with practice improvement efforts.
Will the PROs be used in the Case Selection and Oral Examination process?
PROs survey data may be utilized by Case List Selectors. If a surgical case with PROs data is one of a Candidate’s 12 cases selected for presentation at the Oral Examination, that information will be uploaded to the Candidate’s supporting documentation as part of the overall case presentation.
What if the patient declines to provide his or her email address or does not want to participate?
The ABOS understands that not all patients may wish to participate in the survey. If a patient tells you or your office staff that he or she does not want to participate, do not provide the patient’s email address and check the “Patient opts out” box. A patient who declines to provide his or her email address will not be sent a survey. Please inform your patients that their email address will not be shared, sold, or used for any purpose other than this ABOS activity. The information collected will only be made available to the ABOS and the candidate. The ABOS views this patient input as valuable, and we ask that you encourage your patients to participate in this important activity.
What if the patient fails to respond to the survey?
Those patients for whom we receive a valid email address and do not respond to the initial request will receive a follow-up email request. If there is no response to the second request, the ABOS will make no further contact. A Candidate’s certification process will not be impacted by his/her patient response rate. However, a Candidate whose entire submitted Case List total patient population (patients 12 and older) opts out of the PROs process will be reviewed by the Credentials Committee and may be subject to deferral.
Why will the ABOS not upload the results of the survey as part of the 12 cases to present?
The ABOS wants Candidates to upload the information so they can place it where they want it and how they would like to present it.
Is it possible to see what a PROMIS survey looks like?
The questions can vary depending on how the patient responds. However, you can see something similar by going to the Health Measures website and then choosing Physical Function on the list.
Do patients see their results?
No, the patient does not see the results. Only the Candidate and ABOS see them.
Will surgeons know which patients have completed a survey?
No, the surgeon will not know who has completed a PRO assessment until the aggregate surgeon specific report is generated after the Case List is finalized.
Can a staff member obtain the patient's information?
Yes, there is a separate login for PRO and a Candidate's staff member can enter the required information.
How do I know whether a staff member has entered all of the patients?
The Candidate can go into Scribe at any time and will see which patients have been registered through the PRO registration page. It is the responsibility of the surgeon to provide oversight of his/her staff on this process.
How can I fix an email addresses that was submitted but we later learned was incorrect?
Log in at abos.org and click on the Part II tab. Click on the Scribe button and then find the record that was added with an incorrect email address. Delete that record. Login to the Patient PRO Registration Page using the Login information provided on your Part II tab. Register the patient with the correct email address, and the PRO survey will be sent to the correct address.
What happens if a patient’s surgery date changes? Will they receive another email?
On or after the new date of surgery, log in at abos.org and click on the Part II tab. Click on the Scribe button and then find the patient and change the date of surgery. If the new surgery date is in May or June, the patient is enrolled in PROs. If the new surgery date is before May or after June, the patient will not be enrolled in PROs. All patients get up to two emails. One on entry and another reminder if they haven’t done it. Changing the date from May/June to another date in May/June in Scribe has no effect. Changing the date to something other than May/June will prevent the reminder from going out if it hasn’t already.
Does this program involve ABOS Diplomates in the ABOS Recertification process?
No. This is only for ABOS Part II Oral Examination Candidates.
Will this be an issue for patient privacy and HIPAA issues?
Patients have to consent to the submission of their email address. In addition, the use of patient emails for the PRO (PROMIS) survey is permissible as part of certification, licensing, and credentialing “health care” activities under HIPAA. This information, as well as survey responses, will be covered by the same business associate agreement that covers all of the patient sensitive information collected by the ABOS in support of ABOS Board Certification and Maintenance of Certification programs.
Will this make the Case List entry process more difficult?
Outcome data has been a part of the Case List required elements for many years. This PRO assessment is an improvement in the collection of this data. This process should not add significant burden. Staff may submit the patient’s email address on the Scribe system at the time surgery is scheduled. The patients will submit their survey responses directly. The process takes the patient 1-2 minutes to complete. Other aspects of the Case List have been streamlined and several data points that were previously collected have been removed. We are committed to streamlining the process of Case List selection and entry.
What is the value to the Candidate?
This program will allow many candidates the opportunity to participate in a national, specialty-focused, computerized adaptive, Patient Reported Outcomes program which is patient-centric and with very low patient burden. The physician specific aggregate data provided by the patients will be available to the surgeon for self-regulated quality improvement. If their institution has a PRO program in place, the institution’s PRO program data may be an acceptable substitute for the ABOS in the future. In addition, the ABOS and ABMS are working with CMS to investigate the possibility that this participation would qualify for credit in the MACRA program.