As an ICHOM Knowledge Partner, The Clinician is helping advance the adoption of patient-reported outcomes by sharing insights and practical approaches to outcomes measurement. In this thought leadership article, they explore how collecting standardized patient-reported outcome measures (PROMs) once can create value across individual patient care, healthcare organizations, and entire health systems.
Measure once, cut many times
Maximising the utility of patient-reported outcomes
A patient-reported measure is, at its simplest, a way of asking whether care is doing what it is meant to do. Is it accurate? Is it timely? Did it help? And most telling of all, does the person on the receiving end feel better for it? When those questions are asked consistently, and at scale, the answers do several things at once: they hold the system accountable for the care it delivers, they justify the funding that sustains it, they give patients real information about their own care, and they show us where care can be made better. You cannot improve what you cannot see.
Remarkably, all of it can flow from a single measurement. Carpenters live by a rule: measure twice, cut once. In outcomes measurement, the more useful discipline is almost the reverse. Capture a patient’s perspective once, accurately and in a standardised form, and you can cut from that single measurement many times over: at the bedside, across a service, and at the level of a whole health system. Each use adds value without adding a single extra question for the patient.
This is the central, and frequently missed, opportunity of patient-reported outcome measures. PROM collection has grown rapidly across specialties and geographies, yet in many organisations the data is gathered for one narrow purpose or left to settle in a silo. The instrument is completed once and used once. But the value of a PROM is not in the act of collecting it. It is in how many decisions it can inform.
The precondition: measure the right things, once
“Measure once” only pays dividends if what you measure is consistent and comparable. A score that cannot be set against a benchmark, tracked over time, or aggregated with others has limited reach beyond the moment it is recorded.
This is why standardisation is the quiet enabler of everything that follows and why the work of ICHOM is so important: their standard sets define the outcomes that matter most to patients for a given condition, in a form designed to be compared across teams, organisations and borders. Captured as structured digital data rather than as a paper score buried in a note, the same measurement becomes legible to a clinician, an analyst and a policymaker alike. Get the “measure once” right, and the “cut many times” becomes possible.
■ At the bedside: the individual
At the individual level, PROMs change the conversation in the room. They surface what matters most to this patient, anchor shared decision-making in the patient’s own priorities, and flag deterioration between appointments that might otherwise go unseen. The clearest evidence comes from oncology. A landmark randomised trial published in JAMA found that patients receiving chemotherapy for metastatic cancer who self-reported symptoms electronically, triggering alerts to their care team, lived a median of roughly five months longer than those given usual care, a difference attributed to earlier intervention before problems escalated. The same brief questionnaire, read in real time, became a clinical safety net.
■ Across the service: the organisation
Aggregate those same responses across a team, clinic or pathway, and the data answers a different question entirely: how well are we doing, and where does our care vary? At this meso level, PROMs let service leaders benchmark units against their peers, identify unwarranted variation, target quality-improvement efforts where it will count, and build the business case for change. Crucially, none of this requires new data collection – only a different lens on data already in hand.
■ Across the system: the population
At the system and population level, the same outcome measurements underpin value-based payment, commissioning, registries and policy. When outcomes are standardised across organisations, they become a currency for comparison. The OECD’s PaRIS initiative, the first international effort of its kind, gathered the outcomes and experiences of more than 107,000 patients across 1,800 primary care practices in 19 countries, giving policymakers a like-for-like view of how systems serve people with chronic conditions, and exposing gaps such as variation in care co-ordination. Decisions about where to invest, what to commission and how to pay for value rest on exactly this kind of evidence.
One measurement, many uses – and what gets in the way
The power of the framing is that these are not three separate data-collection exercises. They are one measurement, read three ways. A single PROM completed in a waiting room can guide a treatment decision that morning, feed a service’s quarterly quality review, and contribute to a national outcomes benchmark – at no incremental burden to the person who provided it. In an environment of finite clinical time and well-documented survey fatigue, that efficiency is not a nice-to-have. It is what makes outcomes measurement sustainable at scale.
So why is the full value so rarely realised? Usually because the data is architected for a single purpose. PROMs collected in a standalone survey tool, captured in non-standardised formats, or trapped in a silo cannot easily be repurposed. Reuse cannot be retrofitted; it has to be designed in from the outset: standardised instruments, structured capture, and integrated analytics that are embedded in the clinical workflow rather than bolted on, and routed simultaneously to the people who need them at each level.
Designing PROMs for reuse
This is the problem The Clinician was built to solve. Our platform captures patient-reported data aligned to ICHOM and other recognised standards and puts it to work at every level: a real-time signal for the care team, a benchmarking and improvement engine for the service, and a standardised feed for system-level reporting and value-based contracts. One measurement, many uses; measure once, cut many times.
For quality and clinical leaders weighing how to get more from the outcomes data they already collect, we would welcome the conversation.
REFERENCES
- Basch E, Deal AM, Dueck AC, et al. Overall survival results of a trial assessing patient-reported outcomes for symptom monitoring during routine cancer treatment. JAMA. 2017;318(2):197–198.
- OECD. Patient-Reported Indicator Surveys (PaRIS): International Survey of People Living with Chronic Conditions. OECD, 2024.
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