Healthcare has gone through a fundamental shift toward patient-centered care — an approach that prioritizes the needs, values, and experiences of the patient in all aspects of care delivery. Rather than being passive recipients, patients are increasingly seen as partners in their own healthcare journeys, with their perspectives playing a critical role in shaping care delivery.
However, it’s not enough to simply gather feedback — the healthcare environment is far too complex. What’s needed is a proactive, continuous, and structured approach to collecting patient insights, one that ensures feedback is systematically used to drive tangible improvements.
This is where PROMs (Patient-Reported Outcome Measures) and PREMs (Patient-Reported Experience Measures) come in. These tools provide a much-needed system for gathering and applying patient feedback that can directly influence care improvement.
In this article, we will explore the role that PROMs and PREMs play in assessing healthcare quality, show examples of PROM and PREM questionnaires, and discuss why they are essential in capturing feedback that truly makes a difference in patient care.
What are patient-reported outcome measures?
Patient-Reported Outcome Measures are tools used to assess health outcomes from the patient’s perspective. Instead of relying solely on clinical data or physician observations, PROMs let us peek into how patients themselves perceive the impact of their treatments or conditions on their overall health and well-being.
These measures capture self-reported health outcomes, focusing on areas that matter most to patients. They can assess:
- Physical function: Things like mobility, pain levels, or the ability to complete daily tasks.
- Quality of life: Capturing how a patient feels about their overall health and life satisfaction.
- Mental health: Including factors such as mood, anxiety, and cognitive function.
- Symptom severity: Evaluating the intensity of symptoms such as pain, fatigue, or nausea.
- Disability and impairment: Measuring limitations or impairments caused by illness or treatment.
PROMs are particularly useful in chronic care settings, where patient outcomes — such as pain management, physical rehabilitation, or emotional health — are long-term concerns.
When should clinics use PROMs?
Clinics should implement PROMs when they want to understand the real-world impact of their treatments or interventions. This could be before and after surgery, during long-term management of chronic diseases, or as part of routine follow-ups to monitor recovery.
They are essential for tracking patient progress, adjusting care plans, and improving patient outcomes based on firsthand feedback.
What are patient-reported experience measures?
While PROMs focus on outcomes, Patient-Reported Experience Measures focus on how patients perceive the quality of care they receive.
PREMs capture insights into a patient’s experience throughout their healthcare journey — from the initial appointment to post-treatment follow-ups. They highlight the non-clinical aspects of care, focusing on the patients’ interactions with healthcare services:
- Communication: Did the healthcare provider explain things clearly? Were they respectful and attentive?
- Access to care: How easy was it to schedule an appointment? Were waiting times reasonable?
- Comfort and safety: Did the patient feel comfortable and cared for throughout the process?
- Coordination of care: Did different aspects of the healthcare system work smoothly together to provide seamless care?
PREMs are vital because they focus on the patient experience. They help clinics understand what works well and where improvements are needed in service delivery.
When should clinics use PREMs?
Since PREMs help healthcare providers improve aspects like communication, patient support, and overall service delivery, clinics should implement them when they want to assess the quality of interactions patients have with their healthcare system. This could be after a hospital stay, during routine check-ups, or after treatment has concluded.
The difference between PROMs and PREMs
Both PROMs and PREMs are essential for healthcare improvement, but they serve different purposes. The key difference is in what they measure:
- PROMs focus on health outcomes — how well a treatment has improved the patient’s physical, mental, or social well-being.
- PREMs are concerned with the experience of care — how patients felt during their interactions with healthcare providers.
When used together, these tools allow clinics to see both the clinical effectiveness of their treatments and the quality of the overall patient experience.
Plus, merging objective health outcomes with subjective patient feedback leads to a combined approach that enables healthcare providers to be responsive to both outcomes and experiences.
Who benefits from PROMs and PREMs?
PROMs and PREMs benefit a range of stakeholders in the healthcare system — from patients to policymakers — because they provide insights that drive better care quality and outcomes.
Patients as key stakeholders
PROMs and PREMs give patients a voice in their care, making them active participants rather than passive recipients. Sharing their experiences and outcomes empowers patients to influence treatment plans, helping healthcare providers tailor care to their specific needs.
As a simple example, a patient with chronic pain might report their level of discomfort through a PROM, prompting their physician to adjust the pain management plan accordingly.
Healthcare providers and teams
For clinicians, PROMs and PREMs provide a clear picture of both treatment outcomes and patient experiences. This helps in monitoring progress, making data-driven adjustments to treatments, and ensuring that care aligns with patient expectations.
For instance, a cardiology team might use PROM data to track a patient’s recovery post-surgery, while PREMs could highlight gaps in communication that need attention.
Healthcare organizations and policymakers
Hospitals, insurance companies, and government bodies use PROMs and PREMs to assess quality, inform policy, and drive improvements.
Insurance companies, for instance, analyze PREM data to understand patient satisfaction, which is closely linked to retention and acquisition. In fact, studies show that higher PREM scores are associated with increased patient loyalty and better health plan performance.
Insurance companies have also been known to adjust reimbursement models based on PREM data, rewarding healthcare providers who consistently deliver high-quality patient experiences.
Researchers and academics
Researchers use PROMs and PREMs to gather data that informs evidence-based practices, clinical trials, and healthcare innovations. Large sets of patient-reported data help identify trends, assess the effectiveness of treatments, and contribute to the development of new care models.
For example, academics studying cancer care may use PROMs to evaluate patient quality of life during chemotherapy, helping refine treatment protocols.
Types of PROM and PREM questionnaires
While some clinics prefer to develop their own PROMs and PREMs, well-established and validated surveys are widely available for use. These validated tools save time and are often more practical to implement, given their rigorous development process.
Common PROM tools
Several widely used PROM tools have been developed to measure various aspects of health. Here are some of the most common ones:
- SF-36 (Short Form Health Survey): One of the most widely used PROM tools. It measures overall health across eight domains, including physical functioning, bodily pain, general health perceptions, and mental health.
- EQ-5D: This tool is popular in both clinical settings and research. It focuses on five dimensions of health such as mobility, self-care, usual activities, pain/discomfort, and anxiety/depression.
- PROMIS (Patient-Reported Outcomes Measurement Information System): Offers a range of measures that assess physical, mental, and social well-being. It is highly flexible, allowing clinicians to select the specific areas they want to assess based on the patient’s condition.
These tools are validated for various patient populations, making them excellent choices for clinics looking to assess health outcomes through patient self-reports.
Examples of PREM surveys
Just like PROMs, there are several established PREMs surveys that clinics can use to gauge patient experiences:
- HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems): Widely used in the US to measure patient experiences in hospitals. It covers communication with doctors and nurses, the responsiveness of hospital staff, and cleanliness, providing insights into hospital service quality.
- NHS Friends and Family Test: Used extensively in the UK, this tool asks patients whether they would recommend the healthcare service to others. It serves as a simple but powerful indicator of overall satisfaction and service quality.
- CARE Measure: Focuses on the quality of the patient-caregiver relationship, particularly the empathy and communication skills of healthcare providers. It’s used to assess whether patients feel understood and supported during their care.
These surveys offer a structured way for clinics to measure various aspects of the patient experience, providing critical feedback that can be used to improve service delivery.
Developing and validating PROMs and PREMs
Creating effective PROM and PREM questionnaires requires:
- Patient involvement: Engaging patients in the development process ensures that the questions reflect the aspects of care that matter most to them. This can include focus groups, interviews, or patient advisory boards.
- Clarity and simplicity: The questions must be clear, easy to understand, and culturally appropriate. A well-designed questionnaire minimizes the risk of misinterpretation and ensures that patients of all backgrounds can respond accurately.
- Reliability and validity: For a questionnaire to be useful, it must consistently produce reliable results across different situations, and be valid (i.e. measure what it is supposed to measure). Rigorous testing is required to ensure these criteria are met.
- Practicality: The questionnaire should be easy to administer and not overly time-consuming for patients to complete. Short-form surveys or digital versions can help maintain engagement while still collecting meaningful data.
If clinics prefer not to develop their own surveys, one simple approach is to borrow questions from other validated tools. This saves time and makes good use of the rigor and testing that established questionnaires have undergone.
How InsiderCX helps clients develop PREM surveys
InsiderCX is a patient experience platform that helps clinics collect, analyze, and act on patient feedback.
All of our clients want to proactively collect patient feedback. However, many don’t know where to start. They need support in figuring out how to systematically survey patients and evaluate their experience.
For that reason, we help every new client develop and deploy PREM surveys based on their goals.
For example, we recently started working with an IVF treatment clinic that wanted to comprehensively track patient experience across the whole patient journey. The goal was to find areas of their service that needed improvement.
So, we helped them develop a questionnaire that covered all patient experience components.
We start with a question that measures the NPS (to gauge overall satisfaction), followed by an open-ended question where patients can leave a general comment about their experience.
After that, the questionnaire is divided into carefully crafted sections that map out the whole patient journey:
- We start with questions that cover experiences before the actual visit. This gives us qualitative insight into specific areas of service like the scheduling process, the helpfulness of the reception staff, and waiting times.
- The next set of questions covers the patient-reported experience during the visit (these questions can differ quite a bit, based on the services the clinic offers).
- Our next question block covers patient experience linked to leaving the clinic. Here, we want to check if patients feel they were given all relevant information and instructions for aftercare.
- Lastly, we round things up by covering the patient-reported experience linked to their overall impression and whether they felt supported during their visit to the clinic.
To get a better idea of how this looks in practice, here is one question from each of those four question groups, in that same order.
Overcoming practical challenges and limitations in using these tools
Successfully integrating PROMs and PREMs in clinical practice requires overcoming several practical obstacles.
Challenges in collecting and analyzing data
One of the biggest hurdles in using PROMs and PREMs is data collection: response rates can be low, especially when surveys are perceived as time-consuming or irrelevant. Literacy barriers and cultural differences can also reduce participation or lead to misunderstandings, impacting the quality of the data collected.
An additional challenge lies in ensuring that the data patients provide is accurate and consistent. Since most PROMs and PREMs rely on patients’ self-reported data, they depend heavily on the patient’s ability to provide precise and honest feedback.
This can be difficult when patients are asked to recall experiences or outcomes after some time has passed. If these tools are used infrequently — e.g. once a year — the data gathered may not reflect real-time trends in patient health or experiences.
Analytics play a crucial role here — clinics often struggle with handling and analyzing large amounts of data generated by PROMs and PREMs. Without proactive and regular feedback loops, healthcare providers may find themselves with data that is outdated or lacks actionable insights.
Limitations of PROMs and PREMs data
Like any self-reported data, PROMs and PREMs are subject to biases. Two of the most common are recall bias and social desirability bias.
Patients may have difficulty accurately remembering details about their treatment or health outcomes, which can distort the data. Alternatively, patients may respond in ways they believe are socially acceptable, rather than providing an honest assessment of their experience or outcome.
The best way to mitigate these biases is using shorter recall periods to reduce memory errors, and anonymous surveys that encourage patients to respond more truthfully. Combining PROMs and PREMs with other clinical data can help validate the patient-reported information and provide a fuller picture of the patient’s health and experience.
Minimizing the clinical workflow impact with digital solutions
Implementing PROMs and PREMs might seem burdensome, but with the right digital solutions, you can automate most of the process.
Automated data collection through mobile apps, telehealth platforms, and digital surveys allows patients to complete surveys quickly and easily. The collected data is automatically processed and reported. Modern systems can also send trigger alerts to care teams when action is needed.
This provides quality and operations teams with actionable insights, allowing them to proactively improve care while reducing administrative strain.
Automate patient insight collection with InsiderCX
Clinics looking to streamline the collection of patient feedback, including PROMs and PREMs, can benefit greatly from using the InsiderCX platform.
Our platform simplifies and automates the entire process, ensuring that collecting valuable patient insights doesn’t become an administrative burden. You can seamlessly integrate patient feedback collection into daily clinic operations, giving your team accurate, real-time data on patient outcomes and experiences.
We also have a team of experts who will support you throughout the entire process — from developing and deploying tailored PREM surveys to analyzing data and finding actionable insights.
In other words, InsiderCX isn’t just a survey tool — it’s an end-to-end solution backed by a team dedicated to ensuring that patient feedback is collected efficiently, analyzed accurately, and turned into meaningful improvements.
Get your clinic the resources it needs to continuously improve both care quality and patient satisfaction. Learn more by reaching out to our team or scheduling a product demo.
