The Difference Between PROMs and HCAHPS in Healthcare and the Power of Using Both

Today, in healthcare, patient experience and outcomes have become critical metrics of success. Two key tools used to measure these aspects are Patient-Reported Outcome Measures (PROMs) and the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). While both aim to capture the patient's voice, they serve distinct purposes and offer unique insights. When integrated into a comprehensive strategy, these tools can provide a more holistic view of patient care, leading to improved outcomes and patient satisfaction.

Understanding PROMs

Patient-Reported Outcome Measures (PROMs) are surveys or questionnaires that patients complete to report on their health status, symptoms, and quality of life from their perspective. PROMs are designed to assess the effectiveness of healthcare interventions by focusing on outcomes that matter most to patients. These measures cover a wide range of domains, including physical functioning, mental health, pain levels, and overall well-being.

PROMs are particularly valuable because they provide direct insights into how patients feel about their health and the care they receive. They can be condition-specific or general, and they are often used in clinical trials, routine clinical practice, and quality improvement initiatives. PROMs help healthcare providers understand the impact of their treatments on patients' lives, allowing for more personalized and effective care.

Understanding HCAHPS

The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a standardized survey instrument used to measure patients' perceptions of their hospital experience. Unlike PROMs, which focus on health outcomes, HCAHPS centers on the patient's experience during their hospital stay. This includes aspects such as communication with doctors and nurses, the responsiveness of hospital staff, cleanliness and quietness of the hospital environment, and the discharge process.

HCAHPS is mandatory for hospitals in the United States that participate in Medicare, and the results are publicly reported. This transparency allows patients to compare hospitals based on their performance and also provides hospitals with benchmarks to assess their own performance. HCAHPS scores are closely tied to hospital reimbursement under value-based purchasing programs, making them a critical metric for hospitals.

Key Differences Between PROMs and HCAHPS

While both PROMs and HCAHPS are essential tools in assessing patient-centered care, they differ significantly in their focus and application:

1. Focus of Measurement:

- PROMs: Focus on patient-reported health outcomes, providing insight into the effectiveness of medical treatments and interventions.

- HCAHPS: Focus on patient experience during a hospital stay, emphasizing service quality, communication, and the hospital environment.

2. Use in Healthcare:

- PROMs: Used primarily to inform clinical decisions, improve care quality, and track the impact of healthcare interventions over time.

- HCAHPS: Used for benchmarking hospital performance, influencing hospital reimbursement, and guiding service improvements.

3. Patient Perspective:

- PROMs: Capture the patient's view of their health and well-being, focusing on outcomes that are directly related to the patient’s condition.

- HCAHPS: Capture the patient's experience with the healthcare system, focusing on how care is delivered.

The Power of Integrating PROMs and HCAHPS

While each of these tools provides valuable insights on its own, deploying both PROMs and HCAHPS as part of a broader healthcare strategy offers a more complete picture of patient care. Here’s why:

1. Comprehensive Assessment:

Using both PROMs and HCAHPS allows healthcare providers to assess both the outcomes and the experience of care. PROMs inform clinicians about the effectiveness of treatments from the patient’s perspective, while HCAHPS provides feedback on the service delivery aspects of care. Together, they create a well-rounded view of the entire patient journey.

2. Enhanced Quality Improvement:

Integrating PROMs and HCAHPS into quality improvement initiatives enables healthcare organizations to address both clinical and experiential aspects of care. For example, if PROMs indicate that patients are not achieving expected health outcomes, providers can use HCAHPS data to explore whether communication or other service factors may be contributing to the issue.

3. Patient-Centered Care:

A strategy that incorporates both PROMs and HCAHPS ensures that care is truly patient-centered. PROMs ensure that clinical care aligns with patient needs and expectations, while HCAHPS ensures that the patient experience is positive and supportive. This dual approach can lead to higher patient satisfaction, better adherence to treatment plans, and ultimately, better health outcomes.

4. Accountability and Transparency:

Public reporting of HCAHPS scores creates accountability for hospitals, while PROMs data can be used internally to drive clinical improvements. Together, they foster a culture of continuous improvement and transparency, where healthcare providers are not only motivated to improve the patient experience but also the health outcomes.

In the complex world of healthcare, no single measure can capture the full spectrum of patient care. PROMs and HCAHPS, when used together, provide complementary insights that are essential for delivering high-quality, patient-centered care. By focusing on both the outcomes and experiences of care, healthcare providers can develop strategies that lead to better patient satisfaction, improved health outcomes, and a stronger, more responsive healthcare system.