AO patient outcomes center: Design, implementation, and evaluation of a software application for the collection of patient-reported outcome measures in orthopedic outpatient clinics

Nan E. Rothrock*, Michael Bass, Andrea Blumenthal, Richard C. Gershon, Beate Hanson, Alexander Joeris, Aaron Kaat, Suzanne Morrison, Robert V. O'Toole, Shalini Patel, Michael Stover, Michael J. Weaver, Raymond White, Maria Varela Diaz, Mark S. Vrahas

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Scopus citations


Background: Patient-reported outcomes are increasingly utilized in routine orthopedic clinical care. Computer adaptive tests (CATs) from the Patient-Reported Outcomes Measurement Information System (PROMIS) offer a brief and precise assessment that is well suited for collection within busy clinical environments. However, software apps that support the administration and scoring of CATs, provide immediate access to patient-reported outcome (PRO) scores, and minimize clinician burden are not widely available. Objective: Our objective was to design, implement, and test the feasibility and usability of a Web-based system for collecting CATs in orthopedic clinics. Methods: AO Patient Outcomes Center (AOPOC) was subjected to 2 rounds of testing. Alpha testing was conducted in 3 orthopedic clinics to evaluate ease of use and feasibility of integration in clinics. Patients completed an assessment of PROMIS CATs and a usability survey. Clinicians participated in a brief semistructured interview. Beta-phase testing evaluated system performance through load testing and usability of the updated version of AOPOC. In both rounds of testing, user satisfaction, bugs, change requests, and performance of PROMIS CATs were captured. Results: Patient feedback supported the ease of use in completing an assessment in AOPOC. Across both phases of testing, clinicians rated AOPOC as easy to use but noted difficulties in integrating a Web-based software application within their clinics. PROMIS CATs performed well; the default assessment of 2 CATs was completed quickly (mean 9.5 items) with a satisfactory range of measurement.

Original languageEnglish (US)
Article numbere10880
JournalJournal of medical Internet research
Issue number4
StatePublished - Apr 2019



  • Orthopedics
  • Patient reported outcome measures
  • Tablet computers

ASJC Scopus subject areas

  • Health Informatics

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