nehf happy, healthy, at home symposium 100117 workshop 3 - r-outcomes

Short Generic PROMsTim Benson

R-Outcomes Ltd10 January 2017

Overview

• Exercise• Our approach• Our tools• Results

Exercise

• Please complete form for yourself (anonymously)

• 4 parts– HowRu health status– Personal wellbeing score– Health confidence score– HowRwe patient experience (most recent GP visit)

• We will process and compare with social prescribing clients to show differences

Donabedian Model

Structure Process Outcome➡ ➡• Structure:

Inputs – staff, equipment and facilities

• Process: Activities – e.g., hospital episodes, outpatient visits, investigations etc.

• Outcome: impact on individuals

Donabedian A. The quality of care: how can it be assessed? JAMA. 1988;260(12):1743-8

R-Outcomes

• howRu – health status• howRwe – patient experience• Personal wellbeing score• Health confidence score

Link to Logo

• Happy – personal wellbeing score• Healthy – howRu• At home – health confidence score• Heart – patient experience – howRwe

Design Principles

1. Generic – Almost all people want the same things

e.g. Happy, healthy at home2. Easy to use surveys

– Short with low reading age3. Standardised

– Validated, comparisons and benchmarking4. Automated5. Reporting, feedback, easy to understand results6. Separate scores for each dimension and overall

Methods of data collection

Person’s own device Providers devicePaperTelephoneAdd to other survey

Best method depends on local context

howRu Health Tracker

howRuA short generic patient-reported outcome measure (PROM)

Physical symptomsMental symptomsDisabilityDependency

Scoring: none = 3, a little = 2, quite a lot = 1, extreme = 0. Overall score is sum of parts 0-12 scaleHigh is always good

Benson T et al. Evaluation of a new short generic measure of health status: howRu. Inf Prim Care 18 (2) 89-101. PDF

Sources:

SF-12 vs howRu: Benson T et al. Evaluation of a new short generic measure of health status: howRu. Inf Prim Care 2010; 18 (2): 89-101. PDF

EQ—5D vs howRu: Benson T et al. Comparison of howRu and EQ-5D measures of health-related quality of life in an outpatient clinic. Inf Prim Care 2013; 21 (1) 12-17. PDF

Validation 1/2

Validation 2/2

Correlations of outcome(Post-op score minus post-op score) Hips Knees

howRu vs Oxford score 0.78 0.86

EQ-5D vs Oxford Score 0.67 0.59

EQ-VAS vs Oxford Score 0.33 0.31

Source: Benson T, Williams DH, Potts HWW. Performance of EQ-5D, howRu and Oxford hip & knee scores in assessing the outcome of hip and knee replacements. BMC Health Services Research 2016; 16:512

Personal Wellbeing Based on UK ONS personal wellbeing questions (2011)

Evaluative Life satisfaction

Eudemonic Overall worthwhileness

Experience Happiness yesterday Anxiety yesterday

Dolan P, Metcalfe R. Measuring subjective wellbeing: recommendations on measures for use by national governments. Journal of social policy 2012, 41 (2), pp. 409-427.

Health ConfidenceThe Health Confidence Score (HCS) is a short generic measure of person’s confidence to engage fully in their own health and care.

KnowledgeSelf-careAccess to helpShared decision-making

Benson T, Bowman C, Potts HWW Development and validation of the Health Confidence Score. Submitted for publication 2016

HCS Validation

Benson T, Bowman C, Potts HWW Development and validation of the Health Confidence Score. 2016

howRweShort generic measure of patient experience:

Clinical aspects1. Kindness2. CommunicationAdmin aspects3. Promptness4. Organisation

Benson T, Potts H. A short generic patient experience questionnaire: howRwe development and validation. BMC Health Services Research 2014, 14:499 PDF

Benson T, Bowman C. Health-Related Quality of Life and Patient Experience in Care Homes. Medicine 2.0 London, Sept 2013

Before and After

Q & A

If you want to know more please contact us:

Tim Benson or Jess DoneR-Outcomes Ltd07855 682 037

tim.benson@r-outcomes.comhttp://www.r-outcomes.com