Patient Reported Outcome Measures in Danish Health Care JAN MAINZ MD; PHD; PROFESSOR, DIRECTOR 1

Patient Reported Outcome Measures in Danish Health Care JAN MAINZ MD; PHD; PROFESSOR, DIRECTOR 1

THE DANISH HEALTHCARE SYSTEM Denmark has 5.5 mio. inhabitants The Danish Health Care System is mainly public owned and run The public health care services is financed by taxes The Health Care system is decentralized to 5 regions It is a fundamental principle, that all citizens should have free and equal access to health care services Freedom of choice of hospitals and general practitioner

NATIONAL QUALITY IMPROVEMENT INITIATIVES The Danish Health Quality Programme National clinical guidelines National clinical registries (databases) National patient satisfaction surveys in somatic and psychiatic hospital and ambulatory care (PREM) National relatives satisfaction surveys in psychiatic hospital and ambulatory care National PROM initiatives National Agency for Patients` Rights and Complaints and reporting of Adverse Events Public disclosure of quality of care data

BOOSTER FOR THE PROM WORK In connection with the national economic agreement for 2017; the Government, the Danish Regions and the Municipalities agreed that patient reported information should be used systematically in daily clinical practice and for quality development in the healthcare system 4

O R G A N I S A T I O N

PROM AT THE NATIONAL LEVEL 6

PROM AT NATIONAL LEVEL Organisation The National PRO working group was established mid 2016. The group must establish a framework that helps to support the use of PRO in daily clinical practice and for quality improvement in all healthcare sectors / across sectors (where relevant) To carry out the work of the working group, a national PRO-secretariat was established end of 2016 Task of the national PRO-secretariat Establish and maintain a PROM-terminology Establish a PROM-Questionnaire Bank Establish guidelines for standardized use of PROM Support adaption of international PROM Sharing knowledge about PROM 7

CLINICAL COORDINATION GROUPS Aim Identify and determine PRO-questions based on what is relevant to the patient and his / her pathway Working mode; workshops different types of including national experts and patient organizations Focus areas; Hip-knee Alloplastic, Stroke, Prostate cancer, Epilepsy, Anxiety and depression

VALUE BASED STEERING Aim Identify and determine indicators that are relevant for value based steering, including PROM National Steering Committee Working mode; workshops different types of including national experts and patient organizations Focus areas; Hip-knee Alloplastic, Stroke, Prostate cancer, Epilepsy, Anxiety and depression

PROM-WORK AT THE CLINICAL REGISTRIES 10

PROM IN THE DANISH CLINICIAL REGISTRIES In June 2015 the Regional Health Directors initiated new development goals for the Danish National Clinical Registries (RKKP). The goals stated that data-driven quality development should be anchored close to the clinical work and driven by patients' and clinical needs. The goals included systematic patient involvement: wide use of PROM, real patient influence on indicator choices, easy and meaningful access to own data and "patients like me feature The current action plan for RPPK includes implementing more PROMs in the 70 clinical registries and meaningful patient involvement in managing the individual databases http://www.rkkp.dk/siteassets/om-rkkp/udviklingsmal-2015/mal-for-videreudvikling-af-de-kliniske-kvalitetsdatabaser_endelig-godken---.pdf http://www.rkkp.dk/om-rkkp/handleplan/

THE FOLLOWING DATABASES HAVE PROM DANBIO (Rheumatology) DugaBase - Danish Urogynological Database Danish Obstetrics Registry Danish Knee Ligament Register Danish Palliative Database Prostate Cancer Danish Lung Cancer Register Shoulder alloplastic Non-melanoma

DANBIO; CONSULTATION COLLABORATION USER LED

PROM-WORK AT THE GP S 14

PRO AT THE GENERAL PARTITIONERS - I Web-Patient is the GPs platform for collection of: measurements patients make at home patient reported outcomes before consultation The GP can see the patient s information in the electronic patient file right after the patient has tipped in the information. The information is collected pre consultation, and support the dialogue and guides the choice of treatment. 15

PROM AT THE GENERAL PARTITIONERS - II Web-Patient collects patients own information on Depression symptoms (MDI) Prostate symptoms (PSS) Self reported anxiety symptoms Headache symptoms Stress symptoms Diabetes symptoms Web-Patient collects patients own measurement on Blood presure Blood sucker Peak flow of the lungs Weight control Fluid and urination 16

PROM-WORK IN THE REGIONS 17

PLANNED AND LAUNCED LOCAL PROJECTS 18

FOCUS OF LOCAL PROM-PROJECTS 19

JAN MAINZ MD - PhD - Professor - Director M: jan.mainz@rn.dk T: +45 25 57 90 33 20