Optimizing Trauma PRO Collection & Utilization | A Client Success Story

February 05, 2024


Orthopedic trauma is a challenging area to measure the quality of care. Patients typically arrive in the ER with little warning and may have other injuries. Patient-reported outcomes (PROs) have been validated in trauma literature as both a reliable and reproducible way to quantify the quality of care delivered and the functional outcome. The challenge for any trauma center is reaching the patients after discharge.

After five years of using manual collection, the organization realized they needed to find a more efficient and cost-effective way to collect and analyze patient data. That’s when they turned to CODE, a digital platform for collecting PROs. With CODE, the organization was able to save money, streamline their database, and collect valuable insights from patient comments that ultimately helped them improve their overall patient experience. Here’s how the organization built a prosperous PRO program and promoted patient participation.

The Challenges of Collecting Patient-Reported Outcomes: A Look at Our Client’s Pre-CODE System

The orthopedic trauma team at our client’s Level 1 Trauma Center had been using paper and hard copies to collect patient-reported outcomes for five years. It was a time-consuming and resource-intensive process, but they knew it was important to track patients’ progress and satisfaction after their procedures. At any given time from 2012-2017, the team had less than 10 participating trauma surgeons and enrolled an average of 433 patients per year: totaling 2,164 patients over the five-year span. As you could imagine, the paper-based system was far from perfect. Manually calculating and storing the data was a hassle, and analyzing the results was a daunting task that required significant resources from the research department. And at an average cost of $171 per patient, the program was expensive to maintain. It was clear that a change was needed to streamline the process and reduce costs. But what was the solution? That’s where CODE came in.

pile of paper patient-reported outcomes

A PRO Program That Packs a Punch: The Results After Partnering with CODE Technology

In 2018, our client partnered with CODE Technology to revolutionize their patient-reported outcomes (PROs) program. They switched from the cumbersome paper-based system to a digital platform that utilized emails, text messages, and reminder phone calls to collect electronic PROs (ePROs). The results were astounding. Over the course of two years, the team enrolled 3,096 patients in 13 different fracture types, which nearly quadrupled their previous average annual enrollment of 1,548 patients.

It wasn’t just the increased enrollment that impressed the team. The ePRO collections demonstrated statistically significant higher capture rates at the 6-month and 1-year follow-ups for all applicable modules (P < 0.05). And the best part? The average cost per patient was reduced from $171 for the paper-based system to just $56 for the ePRO platform – 1/3 of the overall cost of paper collections. 

The success of the ePRO program allowed for the PROs program to see vast expansion, thanks to increased resource availability. What was once a program with less than 10 participating trauma surgeons at a single location is now a collaborative effort across 28 trauma surgeons, 6 locations, 4 different EHR systems, and 2 hospital systems. The PROs registry matured with over 10,500 patients enrolled, and the client now collects 14 different PRO tools across 15 different trauma procedures based on anatomical region.

The results speak for themselves – with over 12,000 PRO assessments completed and a rich, qualitative dataset from almost 5,000 patient comments stored. It’s clear that the decision to partner with CODE Technology has a profound impact on the client’s PRO program, streamlining the process and saving resources, while providing better outcomes for patients.

“Diving into the data that has matured over many years is so insightful: there are so many lessons that can be learned from both aggregate and individual patient data! Registries that grow to be this large are not possible without the commitment of the care team educating patients on the purpose of completing their assessments. This organization is an excellent example of how value is augmented by the care team’s consistent and focused collection efforts.”

Emily Pickup | Account Manager

graph showing registry growth

The Power of Patient Feedback: How Patient Comments Are Improving Trauma Care

Given the nature of orthopedic trauma, the patient burden is significantly higher than elective orthopedic procedures. So, how can an organization make the difference less drastic? The client knew the best way to find the answer was by listening to their patients. By prompting the patients to leave comments on each assessment, they opened the door to valuable insights into what really matters to their patients. On top of their already impressive capture rate, over ⅓ (36%) of enrolled patients left additional comments when completing their PROs assessment.

 “Analysis of patient narrative responses provides valuable
information to improve patient-centered, value-based care.”

Analysis of Patient Comments on Patient-Reported Outcome Measures in Orthopaedic Trauma

Through careful analysis of patient comments, the trauma team identified nine key areas that had a significant impact on the patient experience. These ranged from positive and negative communication with the care team, to empathy, pain management, and more. And while functional outcomes were certainly important, it was clear that other non-medical aspects of care were just as critical. The most frequently cited comments were related to interactions patients had with their surgical team and communication (68%) while only 14% of comments were related to functional outcomes.

Doctor looking at xray and referencing an outcome survey

“While orthopaedists tend to closely monitor functional outcomes in the outpatient setting, they may put less emphasis on other important aspects of care such as gratitude, effective communication, and empathy. Perhaps more focus should be shifted toward the non-medical aspects of orthopaedic trauma care in the non-emergent environment.”

Analysis of Patient Comments on Patient-Reported Outcome Measures in Orthopaedic Trauma


Moving forward, our client’s experience serves as a powerful reminder of the importance of patient-centered care. By listening closely to the voices of those we serve, we can all work together to improve the quality and value of healthcare for all.

Maximize Outcomes and Improve Care Satisfaction with CODE Technology

Ready to take your organization’s value-based care initiatives to the next level with the power of patient-reported outcomes? Sign up for a demo today to see how we can help you collect and analyze meaningful data to drive superior patient care.