Patient Trajectories with High-Frequency PROMs Integrated into EHR Systems: A Comprehensive Outcome for Clinical Research and Care.

This study assessed the technical and clinical feasibility of capturing detailed, high-frequency Patient-Reported Outcome Measure (PROM) trajectories by integrating short instruments directly into the Electronic Health Record (EHR) system. Current practice uses infrequent PROMs, failing to capture the dynamic nature of a patient's trajectory. We designed and implemented an electronic data capture system that securely sent single-item Quality of Life (QoL) and pain assessments to patients' smartphones for direct EHR integration. The system was tested in cohorts from neurosurgery (182 patients, every 2-3 days for 30 days) and psychosomatics (71 patients, weekly for 60 days). Results showed high temporal variability in QoL (mean coefficient of variation 30.5% in neurosurgery), underscoring the need for frequent assessment. The single-item QoL demonstrated clinical validity, correlating highly significantly with pain (p<10E-10). We successfully maintained high response rates, finding that the combination of EHR integration (providing clinical relevance) and short instruments (minimizing burden) is crucial for success. These high-resolution patient trajectories are feasible in real-world settings, offering a powerful tool for both personalized clinical management (e.g., early complication detection) and serving as a comprehensive outcome for future clinical research which can be more informative than survival.