AUTHOR=del Olmo Rodríguez Marta , Martos Martinez Rafael , Pascual Martínez Adriana , Miranda Castillo Carolina , Short Apellaniz Jorge , Pfang Bernadette , Baca-García Enrique , Córdoba Mascuñano Raúl 

TITLE=Closing the value-based circle in shared decision-making: a digital framework for informing the shared decision-making process through patient reported outcome and experience measures

JOURNAL=Frontiers in Public Health

VOLUME=Volume 12 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2024.1452440

DOI=10.3389/fpubh.2024.1452440

ISSN=2296-2565

ABSTRACT=Background
Spreading adoption of value-based models of healthcare delivery has the potential to enrich the decision-making process with patient-reported data. 
Methods 
We describe the potential of PROMs and PREMs within the decision-making process and present a digital framework for informing the shared decision-making process using aggregated data from a healthcare system PROMs and PREMs program, including early results from implementation in hospital network in Madrid, Spain.
Results
The proposed digital framework incorporates aggregated data from a hospital network PROMs and PREMs program as part of a digital patient decision aid (PDA) for patients with lymphoma. After the first hematologist appointment, participating patients access the PDA to review relevant information about clinical and patient-reported outcomes for each of the possible options, assign a personal order of priority to different outcomes, and then select their preferred course of action. Patients’ answers are automatically uploaded to the EHR and discussed with hematologists at the next appointment. Patients are invited to participate in the network PROMs program; participants’ PROMs data are fed back into the PDA, thus “closing the circle” between the decision-making process and patient-reported data collection. 
Conclusion
Obstacles towards widespread implementation of SDM include time constraints, lack of motivation, and resistance to change. Support and active engagement from policy makers and healthcare managers is key to overcome hurdles for capturing patient-reported data and carrying out shared decision-making at healthcare system level. Early results of a digital framework for PRO-enriched SDM seem to be beneficial to the decision-making process.