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Hip & Knee Patient-Reported Outcome Measures (PROMs) – Information for Healthcare Providers

All patients having a consult for elective hip or knee surgery in Ontario should have an opportunity to complete the Patient Reported Outcomes Measures (PROMs) survey.

Here you will find information for healthcare providers about the survey and the system (called “ISAAC”) used to collect the data.

For an overview of the program and purpose, see Patient-Reported Outcomes – Orthopedic (Hip & Knee).

For information to share with patients, including how to complete the survey, see Hip & Knee Patient-Reported Outcomes Survey.

PROMs Data Collection

Information collected through the PROMs survey

One question identifying the patient’s joint and laterality of focus
Three types of PROMs
- Oxford Hip Score (12 items)
- Oxford Knee Score (12 items)
- EQ-5D-5L (6 items)
One question assessing the patient’s general health
One question assessing the patient’s satisfaction with care

When to capture PROMs

Mandatory PROMs collection times:

Pre-surgical assessment (within 2 months before surgery)
Post-operative assessment (within 3 to 5 months post-surgery)
One-year post-operative assessment (within 9 to 15 months post-surgery)

*Collection at the Rapid Assess Clinic (RAC) is optional.

Talking to Patients About PROMs

Completing the survey

On average, it takes patients approximately 5 minutes to complete the survey.
Patients are required to complete all questions on the ISAAC electronic platform. Answers are saved automatically after each of the 3 types of PROMs is completed.

Making corrections in ISAAC

While completing the surveys on ISAAC, patients can select the ”Back” button to correct a response at any time.
Once they select ”Submit,” patients cannot go back and correct their responses in ISAAC.
If the patient requests it, the site-level administrator(s) can make changes to patient survey responses through the ISAAC administrative portal.

Encouraging patients to complete the PROMs survey

Here are some things you can tell patients to get them to complete the survey:

PROMs complement existing clinical tools and give patients a chance to tell their care providers how they are doing.
PROMs allow care providers to track a patient’s progress over time and can be actively used during the patient’s clinic visit.

Refusing to complete the PROMs survey

Patients are not required to complete the PROMs survey, but sites are required to offer them the opportunity to do so at each of the specified times (see: When to capture PROMs). If a patient refuses to complete PROMs, this is no fault of the clinical team. The patient can proceed with their clinic visit without completing PROMs.
There is no centrally reported PROMs response rate indicator linked to funding. Clinics or hospitals will not be penalized for patient refusals.

Promoting PROMs survey completion outside of clinic visits

If patients are not visiting the clinic for their post-operative assessments, try these strategies to promote PROMs survey completion:

Include the survey URL and date required for completion in a patient’s appointment card.
At the patient’s first visit, ask for their consent to send survey reminders by email.
Call the patient to remind them to complete the survey.
Mail a paper copy of the survey to the patient.

Languages available

The PROMs survey is available electronically on ISAAC in English and French only.
Hospitals can provide paper copies of the PROMs survey in selected other languages.

Patient Access to the Survey Through the ISAAC (Interactive Symptom Assessment and Collection) System

Specific clinic registration required for access to ISAAC

Each kiosk with the ISAAC system is registered under a specific clinic site. To access a kiosk, the patient must be registered at that clinic.

Completing PROMs surveys in ISAAC at home

Patients can complete the PROMs survey on any electronic device (at home or clinic) connected to the internet by visiting https://orthopedic-isaac.ccohealth.ca/.
ISAAC is safe to use from home because it is a standardized and secure web-based tool.
The first ISAAC screen asks patients to enter their 10-digit Health Card Number (no letters, no spaces), or their Medical Record Number (MRN).
Patient responses from home will be available in real-time through the ISAAC Administrator portal.

Clinical and Administrator Access to PROMs Data in ISAAC

Access to patient-level data in ISAAC

The hospital’s information technology super users, clinicians and other staff directly involved in clinic flow or patient care should have access to PROMs data.
ISAAC is a secure web-responsive electronic platform. Access to patient-level information is granted according to a Local Registration Authority (LRA) model, as outlined in the Service License Agreement. The LRA will grant a login user account to ISAAC Administrators, who will, in turn, grant access to real-time patient-level PROMs data.

Requesting access to the ISAAC administrator portal

To request access, contact your facility’s designated Local Registration Authority (LRA), appointed by the facility’s legally responsible person.
The LRA is responsible for performing user identity checks, completing and submitting the ISAAC User Registration Form to the ISAAC mailbox.
Our Service Desk will process the submitted registration form after the ISAAC Team confirms that it is complete. The Access Control Team will then create the accounts and provide each new user with a security pin to access the ISAAC Administrator portal.
If you have questions about the request process or need help to identify your facility’s LRA, please email the ISAAC mailbox.

Withdrawing patient information and historical responses from ISAAC

The patient should contact the hospital registration desk to withdraw from ISAAC. The hospital’s ISAAC administrator(s) can notify the ISAAC product team by email.
The ISAAC product team will remove all requested data and records in the ISAAC system and return the data back to the ISAAC site (hospital) where the data originated. The data will be retained in accordance with the hospital’s records retention policy.

Privacy of ISAAC patient records

In ISAAC, each clinic is identified as either an oncology site or an orthopedics site. An ISAAC administrator can only access data for patients registered under their particular site (e.g., oncology). They do not have access to patient data from another clinic site (e.g., orthopedics) or hospital.