The National Center for Advancing Translational Science (NCATS), a component of the NIH, has awarded a consortium of nine universities with $6.3 million to integrate patient-reported outcomes into electronic health records (EHRs). In addition to UAB, the multisite grant will be shared by consortium lead Northwestern University, University of Chicago, University of Illinois at Chicago, University of Alabama at Birmingham, University of Kentucky, University of Florida, University of Utah, Harvard Catalyst CTS and Southern California CTSI. Cerner and Epic will participate as integration collaborators. 

The goal of the project, the EHR Access to Seamless Integration of PROMIS (EASI-PRO), is to make it easier for investigators and clinicians to collect patient-reported information and use it to improve clinical care and research. PROMIS (the Patient Reported Outcomes Measurement Information System), a computerized survey tool that adapts to each patient’s unique answers, will be added to the EHR of patients enrolled in clinical studies, along with their medical information. This will enable comparison of medical information with outcome survey responses, “which studies have shown is one of the best ways to improve health care quality and the impact of research,” according to Northwestern, which has already integrated PROMIS into its Medicine EHR. 

Integration of PROMIS into a large number of EHRs will enable health care systems across the country to administer the same patient-reported outcomes surveys and compare the results. Because it is adaptive, PROMIS also has the potential to make patient-reported outcomes surveys up to 10 times shorter, making it less of a burden on those who take it. 

The Easi-PRO team is building software that will integrate PROMIS into Cerner and Epic EHRs. At UAB, the plan is “to move patient outcomes data into i2b2 as soon as PROMIS is integrated into Cerner,” said UAB Informatics Institute Director Dr. James J. Cimino, one of the co-PIs on the grant. He anticipated this would occur in Year 2 (~ 2018). 

Cimino explained the project represents an important development in the history of EHRs. “The mechanisms we use for capturing and storing these data will be archetypes for all sorts of additional data, such as patient preferences, advance directives, and the like. We cannot move to the next-generation EHR until the patient is able to be a full partner in contributing to the system. This is a step in that direction.”