September 2, 2022

Best practices for PROMs compliance

If you’re reading this, you’re already convinced that collecting outcomes that matter to patients is valuable. And if you're not, you should first read the article Rik wrote about the advantages of collecting PROMs.

If  you’ve ever been part of a care team that collects patient-reported outcomes (PROMs), you’ve likely also noticed that, despite everyone being convinced of the value, getting patients to actually fill in the questionnaires is difficult. And that leads to response rates that are frequently lower than expected.

As a platform that supports PROMs collection, we’re often asked: How compliant are patients when it comes to filling in their questionnaires?

Our answer is that, as with most things in life, it depends. But there are steps you can take to ensure you’re seeing a higher response rate. Thanks to several years of working with care teams and patients, we’ve been able to pinpoint the 5 best practices that, when implemented, will help you increase data collection from patients — and make life easier for the whole care team.

1.  More than data collection

What’s in it for the patient?

For many patients, there’s no immediate value for filling in their questionnaires. Especially when there’s such a delay in when that data actually gets analysed and used. The best way to motivate patients is by putting their data to work immediately after it’s received; instead of layering data collection on top of an existing care delivery process, integrate the data into the immediate care given.

Best Practice: Send dynamic tips based on the data entered by the patient. Show how the key indicators they’re contributing to with their data are evolving. Ask open questions a day before the consultation and actually discuss the topics that are flagged by the patient.

Seeing their data put to use as they’re moving through the care pathway will keep patients motivated to fill out their questionnaires — because they’ll be able to understand their value in real-time.

Tech Tip: Use Awell Health software to configure dynamic tips, messages, and alerts, or to offer simple data visuals, so your patients can track their progress and see their responses at work.

2. Consistent experience and automation

Sure, giving a paper questionnaire to the patient while they’re waiting for a consultation might require little effort — but what happens when the patient gets home? Are future outcomes recorded in a smartphone app? Online? Do they receive a paper questionnaire via snail mail?

As absurd as it sounds in today’s digital era, many care teams are still opting for the paper route — or a hybrid route that offers paper questionnaires in the clinic or hospital, and digital questionnaires when the patient’s responding from home.

However, not only does paper-driven data collection lead to issues with data processing, but it also results in a broken process for patients — leaving them less inclined to fill in their questionnaires. And what’s worse? Outcomes collection timelines are becoming more and more complex, with different registries and data collection efforts requiring specific variables to be collected at specific points of time throughout the care pathway. Good luck sending manual reminders based on spreadsheets in Excel efficiently.

Best Practice: Use technology to provide patients with a consistent experience from inclusion in an outcomes collection track all the way through to the end of their care pathway. Sending automated reminders is effortless for most software tools, so take the burden off of your care team and let technology do the boring, repetitive stuff.

Tech Tip: Use Awell Health software to automate complex data collection tracks such as ICHOM standard sets so your care team can “set and forget.”

3. “Please fill in a questionnaire”

We still have yet to encounter the patient who wished they’d gotten to fill out more questionnaires during their care journey. Let’s face it: filling in questionnaires is something clinicians want, not patients. So, to increase response rates, let’s reframe our data collection method so it doesn’t deter patients from participating.

Best Practice: Stop calling them “questionnaires.” Stop making them look like questionnaires.

Tech Tip: Use Awell Health software to provide patients with conversational-style flows that collect outcomes, so they actually enjoy reporting their experiences.

4. Don’t make it optional

In one of our projects, we saw a below-average response rate from patients. We wanted to know why, so we followed up with one of the clinicians — and learned that he’d requested his patients’ participation in data collection as though it would be a favor.

“If you feel like it,” “When you have time,” “Whether you might consider filling this in at home” — these were the phrases the clinician had used when telling his patients about the questionnaires.

Today, there’s still a strong incentive for patients to do as the doctor says. So, if a clinician tells their patient to do something — like fill in a questionnaire, for instance — the odds are good that they’ll do it. But only if the phrasing is right.

Best Practice: When you’re including outcomes data collection in your care, have a proper intake with your patient where you explain that questionnaire-driven data collection isn’t an optional model. You should also be sure to mention that future cohorts of patients will experience more value if they comply with the data collection process now.

Tech Tip: While this best practice doesn’t rely on any technology directly, going over how simple, quick, and effective the technology makes data collection with your patients will help them be persuaded to complete the questionnaires. You should be stressing the importance of compliance and the ease of compliance in equal parts.

5. The back of the computer screen

The last time you went to see a doctor, were you able to see what they were looking at on their computer screen?

It’s an eye-opening experience for both patients and clinicians when they can look at the same data at the same time. It’s empowering for the patients, as they get a front-row look at their own health progression, and it’s valuable to clinicians, as they’re able to discern what matters most to their patients (and discuss it in real-time).

Best Practice: When you’re collecting data, turn it into visual charts, graphs, and representations to uncover insights like trends and blockers. Show an individual patient’s progress compared to the population. But whatever you do, be sure to be showing your patient those visuals too — so they can see, and understand, everything you do.

Not only is this a necessary strategy for shared decision making, but it’ll also make conversations in the care pathway data-driven and motivate your patient to continue contributing their data. We assure you: when a patient doesn’t fill in their questionnaire and ends up in the consultation with a doctor who says, “If you’d have filled in your data, we’d be looking at your progress together right now,” they won’t make the same mistake again.

Tech Tip: Use Awell Health software to build visual dashboards of your outcomes data easily, equipping you to show easy-to-understand insights to patients so they can become an informed decision-maker in their health journey.


In this article, we proposed 5 best practices to improve response rates with patients:

  1. Reorganize your process, putting the patient-reported data to work immediately.
  2. Provide a simple, consistent, and automated experience with user-friendly technology such as Awell Health.
  3. Think less in terms of “questionnaires,” and more in terms of a continuous flow of information between care team and patient.
  4. Highlight the importance of the patient’s compliance for themselves and future patients.
  5. Elevate the patient to your level by looking at the data together, showing them how their responses can fuel the value of their care.

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