Implementing Electronic Patient-Reported Outcome Measures in Outpatient Cosmetic Surgery Clinics: An Exploratory Qualitative Study.

Background: Patient-reported outcome measure (PROM) data are increasingly being collected over the internet or on a smart device using electronic versions (e-PROMs). Limited evidence exists about factors influencing e-PROM implementation in outpatient clinics.

Objectives: To identify barriers to collection of PRO data from different locations (home or cosmetic surgery office) and using different modes (paper vs. e-PROM) from the perspective of patients, plastic surgeons and clinic administrative staff; and to explore patient preferences for the design of e-PROM platforms.

Methods: Semi-structured interviews were conducted with 11 patients, 3 cosmetic surgeons, and administrative staff. Patients were shown one of the three PROMs (ie, the BODY-Q Satisfaction with Body scale, BREAST-Q Augmentation Module Satisfaction with Breast scale, or FACE-Q Satisfaction with Facial Appearance scale). The formats included paper and electronic (REDCap and TickiT) on tablet and laptop computer. The interviews were audio-recorded and transcribed verbatim. Qualitative descriptive analysis was conducted.

Results: Patients and providers preferred electronic over paper format. The flexibility of the hardware, data entry point (remote location vs. point-of-care) and the privacy of the data were the most recurring themes from the patient's perspective. The objective of collecting PROM data, role in peer-benchmarking and return on investment were key to surgeons and administrative staff.

Conclusions: The e-PROMs were well accepted in the community setting by the patients and the plastic surgeons alike. The design and interface features of e-PROMs were explored in this study, which may be useful for future, mixed method studies evaluating the implementation of e-PROMs.