A social return on investment analysis of patient-reported outcome measures in value-based healthcare

ObjectivesThere is growing interest in the use of Patient Reported Outcome Measures (PROMs) to improve patient and healthcare service outcomes. This study aimed to measure the social and economic value of PROMs implemented within a VBHC framework.MethodsWe conducted a Social-Return on Investment (SROI) analysis in Epilepsy, Heart Failure, and Parkinson's Disease services, to measure the value generated by PROMs for patients and the healthcare provider.ResultsThe SROI analysis revealed substantial variation in the value derived from the PROMs intervention across different services. The highest value was observed in Heart Failure with an SROI ratio of 5.55:1, which represents a substantial return on investment for patients and services. In contrast, the Parkinson's Disease service had small return on investment from PROMs with an SROI ratio of 1.29:1. In Epilepsy, the social value derived from PROMs was proportionally less than the investment made, with an SROI ratio of 0.85:1.ConclusionThese findings demonstrate the complexities of implementing PROMs within a clinical context, and careful consideration is likely needed in selecting suitable services and tailoring the implementation of PROMs to effectively meet specific service and patient requirements. Where PROMs yielded low or no value, the lack of return-on-investment prompts a strategic re-evaluation regarding how PROMs are funded, implemented, and utilized. As the first economic evaluation of PROMs in clinical practice, this study is a novel contribution to the emergent VBHC and PROMs evidence base. Furthermore, the findings from this study will inform recommendations to improve PROMs delivery across Wales.