PROMs and PREMs are becoming increasingly important tools used by hospitals and healthcare organizations to measure the quality of care from the patient’s perspective. They answer two key questions: what treatment outcome does the patient experience, and how does the patient assess their experience of receiving healthcare?
Implementing PROMs and PREMs in a hospital does not have to involve a complex IT project. With the SurveyLab survey platform, healthcare organizations can create a digital system covering survey design, automated distribution, response collection, reminders, reporting, and integration with the organization’s IT systems.
What Are PROMs and PREMs?
PROMs (Patient-Reported Outcome Measures) and PREMs (Patient-Reported Experience Measures) are among the most important methods for collecting information directly from patients.
Although both approaches use surveys, they have different objectives.
PROMs – Patient-Reported Outcome Measures
PROMs are used to measure treatment outcomes reported directly by the patient.
A PROM survey may cover areas such as:
- pain,
- physical functioning,
- quality of life,
- severity of symptoms,
- independence,
- everyday functioning,
- mental well-being,
- return to work,
- the impact of a disease on everyday life.
One of the most important features of PROMs is the ability to compare the patient’s condition before and after treatment.
For example, a patient may complete a PROM survey before surgery and then complete another survey 6 weeks and 3 months after the procedure.
This allows the healthcare organization to determine not only whether a medical procedure was performed, but also how the patient assesses its outcome.
PREMs – Patient-Reported Experience Measures
PREMs measure patients’ experiences of the care process.
A PREM survey may cover areas such as:
- access to healthcare services,
- waiting times,
- contact with staff,
- communication with physicians,
- clarity of information,
- patient involvement in the treatment process,
- organization of hospitalization,
- hospital conditions,
- coordination of care,
- preparation for discharge,
- feeling of safety.
PREMs therefore primarily answer the question:
“How does the patient assess the way they received care?”
PROMs, on the other hand, answer:
“What treatment outcome does the patient experience?”
PROM vs. PREM – What Is the Difference?
The difference can be summarized as follows:
| PROM | PREM |
|---|---|
| Measures treatment outcomes | Measures patient experience |
| Focuses on health status | Focuses on the care process |
| Pain, functioning, quality of life | Communication, organization, accessibility |
| Often measured before and after treatment | Often measured during or after contact with the healthcare organization |
| Shows outcomes from the patient’s perspective | Shows the quality of the patient experience |
PROMs and PREMs are best used together.
This allows hospitals to obtain a much more comprehensive picture of the quality of care.
For example:
PROM results show that 85% of patients experienced significant improvement after the procedure.
At the same time:
PREM results show that patients rate the information provided before the procedure poorly.
The conclusion is clear: treatment outcomes are good, but communication with patients needs improvement.
Why Implement PROMs and PREMs in a Hospital?
Traditional quality indicators often rely on clinical and operational data.
These indicators are extremely important, but they do not tell the whole story.
A patient may have a satisfactory clinical outcome while simultaneously:
- not understanding the medical recommendations,
- experiencing difficulties accessing information,
- rating communication poorly,
- not knowing what to do after discharge,
- experiencing problems that are not recorded in the medical documentation.
PROMs and PREMs complement clinical data with the patient’s perspective.
This makes it possible to build a more comprehensive quality management system.
How to Implement PROMs and PREMs in a Healthcare Organization
Successful implementation is best divided into several stages.
1. Define the Objective of the Survey
Before creating a survey, determine what you want to measure and why.
Possible objectives include:
- assessing treatment outcomes,
- measuring quality of life,
- monitoring patient experiences,
- assessing communication,
- improving the organization of hospitalization,
- monitoring the quality of specific procedures,
- comparing results between departments,
- identifying problems requiring corrective action.
Without a clearly defined objective, it is easy to create a survey that is too long and generates a large amount of data but provides little useful information.
2. Select a Procedure or Patient Pathway
There is no need to implement PROMs and PREMs across every area of hospital activity immediately.
A pilot project is often the best approach.
For example:
Orthopedic department → total knee replacement
or:
Cardiology → a specific treatment pathway for patients with heart disease.
Once the process has been tested, the solution can be expanded to other departments.
3. Design the PROM Survey
The survey should measure aspects of health that are relevant to the specific disease or procedure.
For PROMs, it is generally advisable to use validated questionnaires whenever possible.
Creating a custom questionnaire is not always the best solution.
Depending on the application, organizations can use:
- general quality-of-life measurement instruments,
- disease-specific questionnaires,
- procedure-specific questionnaires,
- additional questions addressing specific symptoms.
4. Prepare the PREM Survey
PREMs can be more directly tailored to the way a particular healthcare organization operates.
Example questions include:
- Did you receive sufficient information about your treatment?
- Was the information provided by staff easy to understand?
- Did the staff answer your questions?
- Did you know what you needed to do after discharge?
- How would you rate the organization of your hospital stay?
- Did you feel safe during your stay?
The number of questions should be limited to those that can provide information useful for decision-making.
5. Define the Measurement Schedule
A single survey is often not enough.
For PROMs in particular, measuring changes over time can provide significant value.
An example schedule:
T0 – before treatment
↓
T1 – after hospitalization
↓
T2 – 6 weeks after treatment
↓
T3 – 3 months after treatment
↓
T4 – 12 months after treatment
This makes it possible to analyze not only an individual score but also changes in scores over time.
SurveyLab for PROM and PREM Implementation
The entire process can be implemented using SurveyLab, a platform for creating and conducting online surveys.
SurveyLab allows organizations to create PROM and PREM surveys and automatically collect patient responses.
The platform supports, among other things:
- online surveys,
- email invitations,
- SMS,
- survey links,
- QR codes,
- automated reminders,
- reporting,
- data exports,
- API integrations,
- webhooks,
- various authentication and access-control mechanisms.
This makes it possible to build a centralized system for measuring patient experiences and outcomes.
How Can PROM/PREM Work in SurveyLab?
An example process could look like this:
Step 1 – The Patient Enters the Hospital
Information about the patient or their treatment pathway is transferred to the survey system.
Step 2 – PROM Before Treatment
The patient receives a link to the survey.
The result is stored in the system.
Step 3 – Treatment
The patient undergoes the planned procedure.
Step 4 – PREM After Hospitalization
After completing their hospital stay, the patient receives a survey about their experience of care.
Step 5 – Automated PROM
After a defined period, the system automatically sends another survey.
Step 6 – Reminder
If the patient has not responded, the system can send a reminder.
Step 7 – Reporting
Results are included in reports and can be analyzed according to predefined criteria.
Integrating SurveyLab with Hospital Systems
For larger healthcare organizations, integration is critical.
The PROM/PREM system can be connected to the existing IT infrastructure.
Examples of data transferred to the platform may include:
- patient ID,
- hospitalization ID,
- department,
- procedure type,
- procedure date,
- date of the next measurement,
- communication channel.
Once the survey has been completed, relevant results or statuses can be transferred back to the hospital system.
SurveyLab provides APIs and integration mechanisms that can be used to automate data exchange between the survey platform and other applications.
Automating PROMs and PREMs
Automation is one of the most important elements of implementation.
Rules can be configured such as:
hospital discharge → send PREM
procedure date + 6 weeks → send PROM
procedure date + 3 months → send PROM
no response → send reminder
This means that staff do not have to manually track which patients should receive the next survey.
Reporting PROM and PREM Results
Data should be available in reports tailored to the needs of different users.
Management Report
It may present:
- results for the entire organization,
- trends,
- department comparisons,
- key indicators,
- areas requiring improvement.
Department Manager Report
It may include:
- results for a specific department,
- results for individual procedures,
- PROM results before and after treatment,
- PREM results,
- patient comments.
Quality Team Report
It can be used for:
- monitoring trends,
- identifying problems,
- evaluating corrective actions,
- comparing results over time.
Key Benefits of Implementing PROMs and PREMs
Better Understanding of Patient Needs
The healthcare organization receives information directly from people using its services.
Measuring Treatment Outcomes
PROMs show treatment outcomes from the patient’s perspective.
Improving Patient Experience
PREMs help identify problems related to organization and communication.
Data-Driven Decision-Making
Instead of relying solely on individual opinions, healthcare organizations can analyze systematically collected data.
Monitoring Change
Regular measurements make it possible to determine whether corrective actions are producing improvements.
Automation
The system can automatically send surveys and reminders and generate reports.
Scalability
After a successful pilot, the system can be expanded to additional departments and procedures.
Key Challenges When Implementing PROMs and PREMs
Technology is only one element of the project.
1. Appropriate Methodology
Not every survey is suitable for measuring treatment outcomes.
For PROMs in particular, it is important to use appropriate, validated instruments.
2. Survey Length
The longer the questionnaire, the greater the risk of lower response rates.
A useful principle is:
measure only what you intend to analyze and use.
3. Appropriate Measurement Timing
PROM measurements before and after treatment need to be carefully planned.
4. Response Rate
A low response rate limits the ability to draw reliable conclusions.
Using multiple communication channels and automated reminders can help improve participation.
5. Patient Data Protection
Health data require a high level of protection.
The project should address, among other things:
- GDPR,
- data minimization,
- access control,
- appropriate data retention,
- encryption,
- pseudonymization or anonymization where appropriate,
- rules governing the processing of medical data.
6. Failure to Use the Results
The biggest problem is not a lack of data.
The problem is collecting data that nobody subsequently uses.
Before launching the survey, it is therefore important to determine:
who will analyze the results, how often, and what actions will be taken if indicators deteriorate.
PROMs and PREMs as Part of Quality Management
The greatest value comes from combining PROM and PREM data with other information.
A model can be created that combines:
clinical data + PROM + PREM + operational data
This provides a much more comprehensive view of healthcare quality.
For example:
A hospital analyzes patient outcomes following a specific procedure.
Clinical data show:
low complication rates.
PROM results show:
patients achieve good improvements in functioning.
PREM results show:
patients rate discharge preparation poorly.
The organization can therefore focus its improvement efforts not on the medical procedure itself, but on the communication and discharge process.
How to Start Implementing PROMs and PREMs
The best approach is to start with a pilot project.
Example Implementation Plan
1. Select one treatment pathway
For example, a specific surgical procedure.
2. Define the objectives
What do we want to measure?
3. Select the PROM
How will we measure treatment outcomes?
4. Prepare the PREM
How will we measure the patient experience?
5. Configure SurveyLab
Surveys, collectors, distribution schedule, reminders, and reports.
6. Integrate
Connect the solution to the hospital system or other data sources.
7. Run the pilot
Launch the survey among a limited group of patients.
8. Analyze
Assess response rates, data quality, and the usefulness of reports.
9. Optimize
Shorten surveys, improve communication, and optimize the data collection process.
10. Scale
Expand the program to additional procedures and departments.
PROM and PREM – FAQ
What does PROM mean?
PROM stands for Patient-Reported Outcome Measures, which are measures of treatment outcomes reported directly by the patient.
What does PREM mean?
PREM stands for Patient-Reported Experience Measures, which are measures of patients’ experiences of the care they receive.
Are PROMs and PREMs patient satisfaction surveys?
Not exactly. Traditional patient satisfaction surveys focus primarily on overall satisfaction. PROMs primarily measure treatment outcomes, while PREMs measure the patient’s experience of the care process.
Can PROMs and PREMs be conducted online?
Yes. Digital surveys allow data to be collected using computers, smartphones, and tablets. Depending on the process, organizations can also use email, SMS, survey links, and QR codes.
Can SurveyLab be integrated with a hospital system?
Yes. SurveyLab provides integration mechanisms, including APIs and webhooks, which can be used to automate data exchange with other systems.
Should PROMs be conducted before and after treatment?
In many applications, this is highly valuable because it makes it possible to analyze changes in the patient’s condition over time. The exact measurement schedule should depend on the objective of the study, the type of procedure, and the PROM instrument being used.
How can response rates for PROM and PREM surveys be increased?
The most important factors are a short and easy-to-understand questionnaire, appropriate timing, a convenient response channel, and automated reminders.
Summary
PROMs and PREMs allow hospitals to measure the quality of care from the patient’s perspective.
PROMs answer the question:
“What treatment outcome has the patient achieved?”
PREMs answer the question:
“How did the patient experience the care process?”
Combining both methods provides a much more comprehensive picture of the quality of healthcare services.
Implementation does not have to be complicated. The best approach is to start with one clinical process, prepare appropriate questionnaires, define the measurement schedule, and automate the entire process.
SurveyLab combines PROM and PREM survey creation, response collection, automated reminders, reporting, and integration with healthcare IT systems in one solution.
This allows hospitals to move from individual patient satisfaction surveys to systematic, data-driven measurement of treatment outcomes and patient experiences.
Start Implementing PROMs and PREMs with SurveyLab
If your healthcare organization wants to start measuring treatment outcomes and patient experiences, SurveyLab can serve as a central platform for managing the entire process – from survey creation and distribution to reporting and integration with organizational systems.
Start with a pilot, measure the results, optimize the process, and then expand PROMs and PREMs to additional areas of your healthcare organization.