AboutMe

AboutMe^TM

What is AboutMe^TM?

ABOUTME™ addresses challenges in Patient-Centered Healthcare Delivery

Healthcare costs continue to rise globally, with factors such as aging populations, chronic disease prevalence, and expensive new medical technologies and advanced therapeutics contributing to rapidly rising costs. In fact, 44% of Canadians aged 20 and over have a chronic condition, 33% of whom reported multimorbidity. Backlogs in medical and surgical care have escalated across Canada as a result of the pandemic which contributes to growing disparities in healthcare and reduced quality of life for affected populations.

Patient-centered care prioritizes the needs, preferences, and values of patients in the care process. There is growing evidence that patient-centered care can be cost-effective in healthcare. While patient-centered care can have many benefits for patients, healthcare providers, and healthcare systems, there are also several challenges associated with providing patient-centered care. ABOUTME™ directly targets pain points in delivering patient-centered care by leveraging cutting-edge software to capture patient and family voices and perspectives using patient-reported outcomes (PROs), providing feedback loops to enhance care, and ultimately improve outcomes. ABOUTME™improves the efficiency and effectiveness of healthcare visits and enhances patient and clinician experience by offering a snapshot of patient symptoms and function and improving communication and shared decision-making based on outcomes meaningful to patients. PROs provide a standardized method of capturing patient perspectives about their health and experiences, complementing traditional clinical measures of health by providing insight into a range of symptoms valued by patients, how well patients can function, and the impact on quality of life. ABOUTME™ offers one of the largest collections available of state-of-the-science PROs including 550+ computer-adaptive tests in English, French, and Spanish from the National Institute of Health (NIH) PROMIS initiative that is continuously updated making it easier for healthcare providers to tailor treatments to patient needs and values to manage chronic conditions more effectively.

AboutMe deployment and benefits across diverse settings

ABOUTME™ is currently implemented across diverse settings. The system is of value to hospitals to improve care quality and rankings among other hospitals, clinicians, and patients to optimize clinical encounter time and support care decisions. ABOUTME™ builds scientific capacity and serves as an interdisciplinary incubator for patient-centered healthcare research across diverse areas such as outcome and decision sciences, mechanistic research, clinical trials, costeffectiveness research, and engagement with key stakeholders. Through the collection of PROs, ABOUTME™ also fulfills a key activity for regulatory bodies in the development and approval of drug and medical device innovations industry and regulatory bodies for licensing, decisionmakers, and researchers to demonstrate the cost-effectiveness of interventions and services and improvement in patient outcomes.

As part of a wellness initiative at Laval University, 271 students completed ABOUTME™ PROs. Reports summarizing the results were provided offering participants insights into their physical and mental health profiles and linking to resources they can access for scores that were below population averages. Feedback from students has been highly positive with 80% indicating that the results will help them seek support from the Wellness Center and/or resources.

In total, 35 and 5 patient partners have worked with our team to develop implementation plans for an upcoming deployment in clinical and community settings. Deployment is planned for March 2023 in six clinical programs including spinal cord injury rehabilitation and interdisciplinary chronic pain programs, and one of the McGill University Health Center internal Medicine wards.

Evidence supports the use of patient-reported outcome measures (PROMs) to enhance patientprovider communication when administered ahead of a clinical visit. Benefits include greater efficiency, enhanced detection of symptoms, and functional impairments to more quickly match patient needs with appropriate services. For example, benefits for the patient-clinician encounter were found by allowing patients to report on symptoms and quality of life before a clinical meeting to allow for better planning of services. The Electronic Medical Record (EMR) system combined patient-reported outcomes with other clinical data to provide graphical trends in the person’s health and treatment, helping the clinician and patient partner to optimize health. Benefits at the clinical service and organization level included, for example, time savings of 7 minutes per patient visit due to automatic data transfer10, adherence to
clinical guidelines improved by 20% pneumococcal vaccination increased 62 to 90%, and colorectal cancer screening from 69 to 81%. An aggregated benchmarking comparison between clinics/services was reported to lead to substantial benefits in the six LHS built around clinical registries.

Optimise patient practice and outcomes with ABOUTME™

Only EPIC, CERNER, and three other electronic medical record vendors have access to the English and Spanish versions of PROMIS computer-adaptive tests (CATs), and none in French. Further insights that can be generated are limited if the data from PROMs is not well understood or integrated into clinical workflows that are conducive to accessing the data in real time at the point of care. The challenges with scaling up PROM electronic systems are related to optimal integration in the clinical workflow, and feedback of PROM scores that are meaningful at the right time and place for clinicians and patients.

ABOUTME™ leverages our team’s 20+ years of experience in using outcomes in clinical care to maximize compliance with collecting PROs in clinical practice. Clinical sites also get access to PRO data when they need it and in meaningful formats at individual patient or clinic aggregate levels. The software includes advanced protocols to customize data collection based on the needs of a clinical program or research initiative.

Cost-effectiveness of ABOUTME™

With clinically objective PROM data from ABOUTME™ clinical sites can catch complications early, show patients’ recovery and track improvements, optimize referral to diagnostic testing, and mental and social health services, and collect valuable feedback at every patient encounter and
in between clinical visits.

There is growing evidence that using PROMs in these ways can be cost-effective in healthcare. PROMs have been shown to help identify patients who may require additional interventions or follow-up care, leading to reduced healthcare utilization and costs. For example, in a study of patients with chronic obstructive pulmonary disease (COPD), the use of PROs led to a reduction in hospital admissions and emergency department visits.

PROs can improve treatment decision-making, including informing shared decision-making between patient and provider leading to better outcomes and reduced costs (references). For example, in a study of patients with breast cancer, the use of PROs led to a reduction in unnecessary treatments, resulting in cost savings.

PROs can also help reduce the burden on patients by providing a standardized way to report symptoms and treatment outcomes. This can reduce the need for additional appointments or tests, leading to cost savings for patients and healthcare systems. By providing a standardized approach, PROMs can help improve patient satisfaction by providing a way for patients to report their experiences and preferences. This can lead to better patient engagement, improved adherence to treatment plans, and ultimately, better outcomes and reduced costs.

Finally, PROs are increasingly being required by regulatory agencies for product approval, and their use can help ensure compliance with regulatory requirements, reducing the risk of costly delays or rejections. Overall, there is evidence that using PROs can be cost-effective by reducing healthcare utilization, improving treatment decision-making, reducing patient burden, improving patient satisfaction, and meeting regulatory requirements. Incorporating ABOUTME™ into healthcare systems and care pathways can provide a range of benefits and ultimately lead to better patient outcomes and reduced costs.

References

1. information Cifh. National health expenditure trends CIHI 1996-2023 [Available from: https://www.cihi.ca/en/national-health-expenditure-trends.
2. Canada. PHAo. Report from the Canadian Chronic Disease Surveillance System: Diabetes in Canada, 2018. 2019.
3. (2021) CMA. Backlogs in medical and surgical care 2021 [Available from: https://www.cma.ca/backlogs-medical-and-surgical-care.
4. McGinnis JM, Stuckhardt L, Saunders R, Smith M. Best care at lower cost: the path to continuously learning health care in America. 2013.
5. Epstein RM, Fiscella K, Lesser CS, Stange KC. Why the nation needs a policy push on patient-centered health care. Health affairs. 2010;29(8):1489-95.
6. Hibbard JH, Greene J. What the evidence shows about patient activation: better health outcomes and care experiences; fewer data on costs. Health affairs. 2013;32(2):207-14.
7. Rickert J. Patient-centered care: what it means and how to get there. Health Affairs Blog. 2012;24(1-4):5.
8. Bennett AV, Jensen RE, Basch E. Electronic patient-reported outcome systems in oncology clinical practice. CA: a cancer journal for clinicians. 2012;62(5):336-47.
9. Basch E, Artz D, Dulko D, Scher K, Sabbatini P, Hensley M, Mitra N, Speakman J, McCabe, M, Schrag D. Patient online self-reporting of toxicity symptoms during chemotherapy. Journal of clinIcal oncology. 2005;23(15):3552-61.
10. McLinden D, Myers S, Seid M, Busch M, Davis D, Murphy J. The learning exchange, a community knowledge commons for learning networks: qualitative evaluation to test acceptability, feasibility, and utility. JMIR Formative Research. 2019;3(1):e9858.
11. Fung-Kee-Fung M, Maziak D, Pantarotto J, Smylie J, Taylor L, Timlin T, Cacciotti T, Villeneuve P, Dennie C, Bornais C. Regional process redesign of lung cancer care: a learning health system pilot project. Current Oncology. 2018;25(1):59-66.
12. Enticott J, Johnson A, Teede H. Learning health systems using data to drive healthcare improvement and impact: a systematic review. BMC health services research. 2021;21:1-16.
13. Marsolo K, Margolis PA, Forrest CB, Colletti RB, Hutton JJ. A digital architecture for a network-based learning health system: integrating chronic care management, quality improvement, and research. eGEMs. 2015;3(1).