AHRQ Patient-Reported Outcome Challenge Competition Support (District of Columbia)

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Patient-reported outcomes (PROs) represent a patient’s perspective of their health, quality of life, and functional status. PROs inform health care decisions, shared decision making, and self-management. Most PRO data are collected via pen and paper, making the data difficult for patients and researchers to access and use. While digital tools have been developed to streamline the collection of PROs, they have not been widely adopted due to workflow integration problems and a lack of data standards. Developing an easily adoptable tool that collects and shares standardized data may solve this problem and advance the state of PROs, benefiting health systems, patients, providers, and researchers.

To address this need, the Agency for Healthcare Research and Quality (AHRQ) sponsored the “Step Up App Challenge: Advancing Care Through Patient Self-Assessments.” AHRQ challenged teams to design, develop, and pilot a user-friendly application (app) to simplify the process of collecting, interpreting, aggregating, and sharing PRO data related to physical function outcomes in the ambulatory care setting. Participants were asked to draft technical specifications employing the HL7 Fast Healthcare Interoperability Resources (FHIR) Standards in their designs. FHIR standards support integration of health data with vendor systems, allowing data exchange across providers and direct use by clinicians and patients.

The specific aims of the research were as follows:

  • Support AHRQ in the design, launch, and management of the Step Up App Challenge. 
  • Administer and manage the challenge competition by maintaining the challenge web page, branding the challenge, developing challenge marketing and communication materials, and coordinating the challenge activities such as facilitating webinars, managing submissions from challenge entrants, and responding to inquiries. 
  • Coordinate and consult with subject matter experts such as physicians, healthcare researchers, and open innovation experts assigned to support the challenge contestants. 
  • Test the effectiveness of using a prize challenge mechanism to advance AHRQ’s research initiatives. 
  • Distribute payments to awardees. 
  • Scan the intellectual property landscape related to digital PRO applications and assist AHRQ in the identification and mitigation of IP issues. 
  • Manage the questions and comments of the community of developers and healthcare innovators participating in the challenge. 
  • Assist Phase 2 winners to create sustainability plans to further develop and refine their products. 
  • Monitor the Phase 3 pilot test and coordinate pilot test logistics with MedStar Health. 

The challenge was conducted in three phases: 1) submission of proposals 2) software development, and 3) pilot test of the overall winning app in ambulatory settings. In Phase 1, over 50 applications were received. Ten finalists were selected to progress to Phase 2 based on originality, feasibility, and executability of their proposed development approach. Judges used an evaluation scorecard to evaluate the merits of assigned submissions, and then all scores were aggregated and normalized to de-bias any significant variance in the judges’ scores. All Top 10 Finalists received $12,500 to fund the development of the application. In Phase 2, the Patient-Reported Outcomes Measurement Information System (PROMIS) Reporting Insight System from Minnesota (PRISMTM) was designated as the winner. The app was developed by a multidisciplinary team from the University of Minnesota’s Carlson School of Management, the Institute for Health Informatics, HealthEast Kidney Stone Institute, and PerkHealth, a Minnesota-based startup mobile app development company. PRISMTM allows patients to record physical function and other measures. Functionality of the app includes score trending, peer group comparisons, and personalized recommendations for followup actions and education materials. Data collected though the app may be integrated with electronic health records and made available to providers for clinical care and shared decision making. For Phase 3, PRISM will be pilot tested in nine practice settings affiliated with MedStar Health in Washington, DC, Maryland, and Virginia.

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AHRQ Step Up App Challenge Summary

Sensis. AHRQ Step Up App Challenge Summary. Prepared under Contract No. HHSA29032001. AHRQ Publication No. 18-0058-1-EF. Rockville, MD: Agency for Healthcare Research and Quality; August 2019. (PDF, 5.85 MB)
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