107 Clinicians’ perspective on PROM implementation Table 3. Advantages and disadvantages of KLIK and the use of PROMs, according to clinicians (N = 148) Advantages of KLIK/PROM use Examples 1. Insight in patient’s functioning ‘You quickly can get an impression of the things that are (not) going well’ ‘Monitoring the patient over time’ ‘Quick overview of how the patient is doing’ 2. Improved communication ‘The KLIK ePROfile structures the consultation’ ‘It provides a starting point for the conversation on difficult topics’ ‘Makes it possible to go in depth more quickly’ 3. Detecting problems ‘Problems are recognized earlier’ ‘It provides information about the disease/person that I would not have discovered otherwise’ ‘Standardized screening’ 4. Insightful feedback ‘Graphs provide insight’ ‘Convenient that scores are calculated directly and automatically’ ‘Better overview of the results through traffic light colors and graphs’ 5. Patients being better prepared ‘Provides patients the opportunity to think in advance about questions and concerns. They are not confronted with these during the consultation’ ‘Patients and parents talk to each other about items that matter’ ‘Patients think in advance about their own functioning and request for help’ 6. Easy to use ‘User-friendly’ ‘Accessible’ ‘Completing PROMs at home is easier for patients/parents’ 7. Time saving ‘The consultation is quicker’ ‘Saves time’ ‘As a clinician, it takes me less time than PROMs on paper’ 8. Clinician was better prepared ‘Better and more targeted preparation of the consultation’ ‘Prior to the consultation, I have important information from patient and parents’ ‘Before the consultation, I already have an impression of the complaints’ Disadvantages of KLIK/PROM use Examples 1. Low responserate ‘Patients often do not complete PROMs’ ‘Patients with problems, for whom KLIK adds value, rarely complete the questionnaires’ ‘Reminders are necessary for patients to complete PROMs’ 2. Takes time for clinician ‘Extra time is needed to prepare the consultation’ ‘It takes time to discuss, since KLIK is not integrated into the EHR’ ‘Motivating patients to complete PROMs takes time’ 3. Irrelevant content of PROMs ‘Not all questions are relevant for every patient’ ‘Patients misunderstand questions’ ‘Many questions’ 4. Complex procedure ‘Patients lose username and password’ ‘PROMs are not easy to complete for parents with a cognitive disability or foreigners’ ‘Not all patients have access to Internet’ 5. Technical aspects ‘It takes effort to log in’ ‘I do not receive an automatic message when patients have completed PROMs’ ‘I have to print the KLIK ePROfile, because we do not have computers in the consultation room’ 6. No integration with EHR ‘The data from KLIK does not end up directly in the EHR’ ‘No integration with Epic©’ ‘Need to open a separate window, besides EHR’ 7. Takes time for patients ‘Requires time investment of patients’ ‘Patients indicate that they sometimes spend a long time completing PROMs’ ‘Extra burden for busy parents’ 4
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