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Viewpoint | Innovations in Health Care Delivery

Incorporating Health Status in Routine Care to Improve Health Care Value The VA Patient Reported Health Status Assessment (PROST) System

Steven M. Bradley, MD, MPH1,2; John S. Rumsfeld, MD, PhD1,2; P. Michael Ho, MD, PhD1,2
[+] Author Affiliations
1VA Eastern Colorado Health Care System, Denver
2University of Colorado School of Medicine, Aurora
JAMA. 2016;316(5):487-488. doi:10.1001/jama.2016.6495.
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This Viewpoint describes the VA Patient Reported Health Status Assessment (PROST) system, designed to capture and prioritize patient-reported health status measures, and discusses early experiences using the system to improve care for veterans undergoing percutaneous coronary intervention.

For more than 2 decades, performance measurement has been used to incentivize improvements in health care quality. However, performance measures have largely focused on care processes that can be weakly linked to patient outcomes, and the proliferation of these measures has become a potential barrier to further quality improvement.1 Refocusing performance measures on health outcomes that reflect the patient’s perspective may help reduce measurement burden and incentivize care delivery improvements that directly improve patient health. Standardized measures of patient-reported health status (including symptoms, functional status, and health-related quality of life) offer a valid, sensitive, and reproducible approach to assess health outcomes from the patient’s perspective,2 but these measures are infrequently captured in clinical care.

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