Slides from the first North East Hampshire and Farnham evaluation symposium on prevention, which took place on the 10 January 2017.

1. Short Generic PROMs
Tim Benson
R-Outcomes Ltd
10 January 2017

2. Overview
• Exercise
• Our approach
• Our tools
• Results

3. Exercise
• Please complete form for yourself
(anonymously)
• 4 parts
– HowRu health status
– Personal wellbeing score
– Health confidence score
– HowRwe patient experience (most recent GP visit)
• We will process and compare with social
prescribing clients to show differences

4. Donabedian Model
Structure ➡ Process ➡ Outcome
• Structure:
Inputs – staff, equipment and facilities
• Process:
Activities – e.g., hospital episodes, outpatient visits,
investigations etc.
• Outcome:
impact on individuals
Donabedian A. The quality of care: how can it be assessed?
JAMA. 1988;260(12):1743-8

5. R-Outcomes
• howRu – health status
• howRwe – patient experience
• Personal wellbeing score
• Health confidence score

6. Link to Logo
• Happy – personal wellbeing score
• Healthy – howRu
• At home – health confidence score
• Heart – patient experience – howRwe

7. Design Principles
1. Generic
– Almost all people want the same things
e.g. Happy, healthy at home
2. Easy to use surveys
– Short with low reading age
3. Standardised
– Validated, comparisons and benchmarking
4. Automated
5. Reporting, feedback, easy to understand results
6. Separate scores for each dimension and overall

8. Methods of data collection
Person’s own device
Providers device
Paper
Telephone
Add to other survey
Best method depends on local
context
howRu Health Tracker

10. howRu
A short generic patient-reported
outcome measure (PROM)
Physical symptoms
Mental symptoms
Disability
Dependency
Scoring:
none = 3, a little = 2, quite a lot = 1, extreme = 0.
Overall score is sum of parts 0-12 scale
High is always good
Benson T et al. Evaluation of a new short
generic measure of health status: howRu. Inf
Prim Care 18 (2) 89-101. PDF

11. Sources:
SF-12 vs howRu: Benson T et al. Evaluation of a new short generic measure of health status: howRu. Inf Prim Care 2010; 18 (2): 89-101. PDF
EQ—5D vs howRu: Benson T et al. Comparison of howRu and EQ-5D measures of health-related quality of life in an outpatient clinic. Inf Prim Care 2013; 21
(1) 12-17. PDF
Validation 1/2

12. Validation 2/2
Correlations of outcome
(Post-op score minus post-op score) Hips Knees
howRu vs Oxford score 0.78 0.86
EQ-5D vs Oxford Score 0.67 0.59
EQ-VAS vs Oxford Score 0.33 0.31
Source: Benson T, Williams DH, Potts HWW. Performance of EQ-5D, howRu and Oxford hip &
knee scores in assessing the outcome of hip and knee replacements. BMC Health Services
Research 2016; 16:512

13. 2. Personal Wellbeing
I was happy yesterday
I was NOT anxious yesterday
What I do in my life is worthwhile
I am satisfied with my life
Strongly
agree
Agree Not sure Disagree
How much do you agree?Personal Wellbeing
Based on UK ONS personal
wellbeing questions (2011)
Evaluative
Life satisfaction
Eudemonic
Overall worthwhileness
Experience
Happiness yesterday
Anxiety yesterday
Dolan P, Metcalfe R. Measuring subjective wellbeing:
recommendations on measures for use by national
governments. Journal of social policy 2012, 41 (2), pp. 409-
427.

14. 3. Health Confidence
I can get the right help if I need it
I am involved in decisions about me
I can look after my health
I know enough about my health
Strongly
agree
Agree Not sure Disagree
How much do you agree?
Health Confidence
The Health Confidence Score (HCS) is
a short generic measure of person’s
confidence to engage fully in their
own health and care.
Knowledge
Self-care
Access to help
Shared decision-making
Benson T, Bowman C, Potts HWW Development and validation
of the Health Confidence Score. Submitted for publication 2016

15. 6
7
8
9
10
4 5 6 7 8 9 10 11 12
Mean MHC
score
Actual HCS Score
Mean MHC vs. actual HCS (n=364)
HCS Validation
Benson T, Bowman C, Potts HWW Development and
validation of the Health Confidence Score. 2016

16. howRwe
Short generic measure of patient
experience:
Clinical aspects
1. Kindness
2. Communication
Admin aspects
3. Promptness
4. Organisation
Benson T, Potts H. A short generic patient
experience questionnaire: howRwe
development and validation. BMC Health
Services Research 2014, 14:499 PDF

17. Benson T, Bowman C. Health-Related Quality of Life and Patient Experience in Care
Homes. Medicine 2.0 London, Sept 2013

18. Before and After

20. Q & A
If you want to know more please contact us:
Tim Benson or Jess Done
R-Outcomes Ltd
07855 682 037
tim.benson@r-outcomes.com
http://www.r-outcomes.com