The Power of Clear Instructions: CMS’s Information Transfer PRO-PM and the Future of Outpatient Care

Outpatient surgeries and procedures now account for a significant portion of healthcare delivery, with increasingly complicated procedures being handled by hospital outpatient departments (HOPD). Despite the popularity of outpatient procedures, studies have shown that patients often leave facilities with incomplete or unclear guidance on recovery _[1]. This can lead to medication errors, delayed healing, or unnecessary emergency visits _[2]. In an effort to address this communication gap, the Centers for Medicare & Medicaid Services (CMS) recently published The Information Transfer Patient-Reported Outcome-Based Performance Measure (PRO-PM).

This mandate relies on patients' self-reported understanding of recovery instructions, from scheduling through discharge _{[1, 2]}. By emphasizing clear communication, CMS seeks to boost patient activation, improve outcomes, and align with broader goals of value-based care _{[1, 2]}.

Introducing the Information Transfer PRO-PM

The Information Transfer PRO-PM, formally known as the Patient Understanding of Key Information Related to Recovery After a Facility-Based Outpatient Procedure or Surgery PRO-PM, is a new quality measure designed to evaluate how effectively HOPDs communicate essential recovery information to patients after elective procedures or surgeries _{[2, 3]}. It is a part of the Hospital Outpatient Quality Reporting (OQR)Program. 

Unlike existing tools like the Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems (OAS CAHPS), this measure specifically targets recovery-related communication, filling a critical gap in outpatient quality metrics _{[1, 2]}. It aims to reduce complications, readmissions, and healthcare costs by ensuring patients leave with clear, personalized instructions tailored to their needs _{[1, 3]}.

Key Details of the Information Transfer PRO-PM

The measure applies to patients aged 18 or older who undergo elective outpatient procedures or surgeries in HOPDs, with a stay of less than two midnights, excluding emergencies and non-elective cases _{[2, 3]}. Here’s a breakdown:

• Survey Instrument: A 9-item questionnaire covering three domains—Patient Needs/Applicability (tailoring instructions), Medications (dosage, side effects), and Daily Activities (resuming routines, warning signs). Patients rate clarity on a scale: "Very Clear," "Somewhat Clear," or "Not Clear," with a "Does not apply" option _{[2, 3]}.
• Administration: Surveys are sent 2-7 days post-procedure, with up to 65 days for responses. They can be completed by patients or caregivers via email, text, or phone _{[2, 3]}.
• Scoring: Uses a "top-box" approach, calculating the percentage of "Very Clear" or "Yes" responses per applicable item. Facility scores average these across patients, without risk adjustment to promote equitable care _{[1, 3]}.
• Data Collection and Submission: HOPDs must collect at least 300 random surveys annually (or all if fewer eligible). Data is submitted via the Hospital Quality Reporting (HQR) system from January 1 to May 15, one year after the reporting period. Hospitals can manage this in-house or partner with third-party vendors _{[1, 3]}.

Implementation is phased: voluntary reporting starts with CY 2026 (data from January-December 2026), becoming mandatory for CY 2027 (affecting CY 2029 payments). Non-compliance could result in a 2% reduction in the annual payment update (APU). 

Preparing for Success: Leveraging PRO Automation

For HOPDs, meeting these requirements means streamlining PRO survey enrollment, administration, and analysis—tasks that can strain resources if done manually _[1]. This is where innovative automation solutions come in. 

At PatientIQ, we specialize in automating PRO workflows with seamless EHR integration, ensuring effortless survey distribution and high response rates. Our platform not only handles enrollment and reminders but also delivers dashboards for data insights, helping facilities monitor performance and identify improvement areas. By integrating with your existing systems, PatientIQ reduces administrative burden, enhances patient engagement, and positions your organization for compliance success.

As CMS rolls out this measure, early adopters who leverage technology will not only meet requirements but also elevate patient experiences _[1]. We're excited to support HOPDs in this journey. Reach out to learn how PatientIQ can tailor our tools to your needs.

Stay tuned for more insights on quality reporting trends. 

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