Abstract—Patient-reported outcomes (PROs) reflect the subjective experience of the patient with respect to their well-being and quality of life. Historically there have been barriers to routine assessment of PROs, including methodological challenges and clinical realities. This paper presents three approaches that have capitalized on clinical realities and technological advances to integrate PROs into an improved case management approach to health care. Empirical data indicate that PROs are prognostic for patient survival and can have profound impact on the course and success of treatment. Keywords—Quality of life, patient-reported outcomes, web- based system, case management. I. INTRODUCTION HE standard tools of clinical practice for assessing, screening and diagnosing the health status of a patient are observer-driven: they rely on medical imaging techniques and processes, laboratory tests, other monitoring or gauging devices, and on the analyses and interpretations of medical professionals. They form the foundation for clinical decision- making in the endeavor to deliver quality medical care to the patient. These biometric approaches, however, do not address or capture the patient‟s subjective impressions of their condition in their daily life, or the subjective patient experiences. It has long-been recognized in medicine as important to understand the perceived quality of an individual‟s daily life, or „quality of life‟ (QOL) [1]. That is, the patient‟s perceived assessment of their general well-being – obtained from the patient rather than the observer – is an important measure of a patient‟s health status. Quality of Life (QOL) is an umbrella term for things other than survival [2]. QOL is measured by patient-reported outcomes (PROs), which are subjective judgments of any aspect of a patient‟s health status that come directly from the patient. PROs can include functional status, symptoms (intensity, frequency), satisfaction (with medication), multiple domains of well-being, and global satisfaction with life. Jeff Sloan is with the Mayo Clinic, Rochester, MN 55902, USA (phone: 507-284-9985; fax: 507-266-2477; jsloan@mayo.edu). Monica Gowan and Joleen Hubbard are with the Mayo Clinic, Rochester, MN 55902, USA (gowan.monica@mayo.edu; hubbard.joleen@mayo.edu). Michele Halyard is with the Mayo Clinic Arizona, Scottsdale, AZ 80309, USA, (halyard.michele@mayo.edu). Elizabeth Sloan is with New England Center for Children, Abu Dhabi (esloan@neccuae.org). At the end of the 20 th Century, a plethora of assessment tools were available for exploring QOL and measuring PROs. The use of PROs, however, was significantly constrained by disappointing clinical trial results that were confounded by missing data, ambiguity on clinical significance, and reliability issues. Today, virtually all validity issues have been either resolved or clear guidelines have been established [3], [4]. Clinicians have always been interested in assessing their patient‟s QOL, but there have been other lingering methodological hurdles to fully incorporating PROs in practice. QOL instrument bases worldwide contain myriad measures of well-being. The length, breadth of scope and the sheer volume of instrument choices alone, however, can make appropriate scale selection and translation from research to clinical practice highly impractical, given time and resource constraints. Further, routine clinical assessment of patient QOL requires measures that are specific and easy to understand for both the clinician and the patient. Brevity and simplicity are also essential for reducing burden on the patient and practitioner. The efficacy and utility of the measures must be clear to the practitioner: “what do I do with PRO data?”, and “how are these data linked to „hard outcomes‟?” The nature of the questions, response options and the results must all be meaningful, relevant and reliable for achieving the clinical practice outcomes of quality patient communication and evidence-based decision making, regardless of the patient‟s level of health literacy. The challenge is to measure QOL through PRO with the observational rigor of any other vital sign or lab test, yet with the ease of administration and rapid processing the clinical environment demands. Much work has been done in the last decade toward the development of a theoretical model of QOL that has now been generally accepted [5]. There are also numerous online psychometric resources to facilitate QOL research. For example, a forms bank has been built which sources validated survey instruments that are applicable in a variety of contexts and generalizable to a wide array of populations (www.qolpro.org). The overarching vision for the work presented in this paper is to apply QOL-related PROs as an „integrated vital sign‟ that helps the health care team quickly understand the baseline resiliency of the patient and potential vulnerabilities to adverse events. This „individualized medicine‟ approach using QOL as a biomarker, equips the provider with a better roadmap for designing not only a treatment program, but also a preventive Incorporating Validated Measures for Patient- reported Outcomes in Clinical Practice Jeff Sloan, Monica Gowan, Joleen Hubbard, Michele Halyard, and Elizabeth Sloan T 3rd International Conference on Chemical, Ecology and Environmental Sciences (ICEES'2014) March 19-20, 2014 Abu Dhabi (UAE) 92