Effectiveness of integrating patient-reported outcome measures into electronic health records for measurement-based care in patients with chronic illnesses: a systematic review
TL;DR
Overall, PROMs appeared to be most useful when they were directly integrated into clinical workflows and used to inform real-time care decisions, and the impact on patient satisfaction, healthcare utilization, and longer-term clinical outcomes was less consistent across studies.
Abstract
Measurement-based care (MBC) has emerged as a promising strategy to support effective chronic disease management. Patient-reported outcome measures (PROMs) are increasingly used to capture patients’ perspectives on symptoms and quality of life, and their integration into electronic health record (EHR) systems may enhance their clinical utility. However, evidence on their impact when embedded within routine clinical workflows remains limited. To systematically identify and synthesize evidence on the impact of integrating patient-reported outcome measures (PROMs) into electronic health record (EHR) systems on clinical care processes and patient outcomes among individuals with chronic conditions. A systematic review was conducted in accordance with PRISMA guidelines. Multiple databases (MEDLINE, Embase, CINAHL, PsycINFO, Cochrane Library, Scopus, and Web of Science) were searched from January 2000 to February 2026. Eligible studies included quantitative research evaluating EHR-integrated PROMs used in routine clinical care for chronic conditions. Data extracted included study characteristics, PROM type, integration approach, and clinical and process-related outcomes. Of 10 included studies, most were conducted in the United States and spanned oncology, rheumatology, primary care, and musculoskeletal settings. Some of these studies reported that EHR-integrated PROMs improved symptom identification and monitoring and were associated with gains in clinic efficiency, including shorter wait times and fewer follow-up visits. Some studies reported reduced healthcare utilization and increased diagnostic activity. However, effects on patient satisfaction, visit volume, and broader clinical outcomes were inconsistent. Heterogeneity in PROMs, implementation approaches, and outcomes precluded meta-analysis. EHR-integrated PROMs may improve symptom monitoring and help clinicians identify patient needs more efficiently within routine chronic disease care. Several studies also reported benefits related to clinic workflow, including shorter wait times, fewer follow-up visits, and improved care coordination. However, the impact on patient satisfaction, healthcare utilization, and longer-term clinical outcomes was less consistent across studies. Overall, PROMs appeared to be most useful when they were directly integrated into clinical workflows and used to inform real-time care decisions. Further research in more diverse patient populations and healthcare settings is needed to better understand their long-term effectiveness and real-world use in chronic disease management. https://www.crd.york.ac.uk/PROSPERO/view/CRD420261297619 , PROSPERO CRD420261297619.