System-Wide Use of Patient Reported Outcome Measures in Organization for Economic Co-operation and Development Countries: Insights From a Health Policy Survey and Key Informant Workshops

Objectives: Patient reported outcome measures (PROMs) can systematically integrate the patient perspective to enhance value-based, people-centered healthcare. This study aims to assess the current systematic use of PROMs data across OECD countries and identify barriers and enablers for system-wide implementation from decision-makers’ perspectives. Methods: A cross-sectional country-level survey was conducted among country officials from 38 OECD member and accession countries and key partners. Two researchers independently coded survey responses. Analysis of barriers and enablers to implementation was guided by the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework and survey results were validated through 2 online workshops, with 72 and 81 key informants, respectively. Results: Among 38 countries surveyed, 44 PROMs programs were identified in 21 countries. Main purposes of data collection were quality improvement (95% of the programs) and quality assurance (55%). The primary users of PROMs data were healthcare professionals (68%), policy makers (59%), and healthcare professional organizations (59%). Programs more frequently engaged healthcare professionals (93%) than patients (81%). In most programs (73%), patients could complete PROMs via online platforms, whereas in less than half (39%) PROMs data were embedded into electronic health records. The most reported barriers to implementation included limited staffing capacity, technological challenges, and insufficient training for both patients and healthcare professionals. Conclusion: Improved resource allocation, meaningful stakeholder engagement, and embedding PROMs into data infrastructures can contribute to system-wide PROMs implementation.