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patient-centered monitoring may also facilitate patients’ management across care
transitions [ 41 ]. ePROMs can enhance cost-effi ciencies [ 20 ]. More ePROMs in
EHRs could even widen the capacity to undertake population-based research [ 42 ].
Assessments with the help of ePROMs (e.g., in electronic diaries) allow to document
time-stamped entries and thereby might positively infl uence compliance [ 43 ]. Visual
feedback for patients—integrated into the Electronic Recording of Outcome Measures
for Infl ammatory arthritis and Ankylosing spondylitis (EROMIA) system —had a posi-
tive and signifi cant impact on the disease activity control [ 44 ]. Recently, a strong cor-
relation was reported between the use of a software application (Rheum-PACER) and
disease control [ 45 ]. ePROMs give the opportunity to obtain a broadened view on dis-
ease courses and patterns also for the empowered patients who proactively participate in
the management of the course of their disease [ 46 ]. In contrast to initial beliefs, patients
have a positive attitude toward the use of PROMs in computerized systems [ 33 ]. As the
public and thereby the patients become more experienced and familiar in the use of new
technologies, ePROMs gain higher acceptability and are commonly preferred by
patients over paper-based versions [ 33 , 40 , 47 , 48 ]. However, recently active ePROM
use in a Web portal was only performed by less than half of the patients [ 49 ].
Not only advantages (pros) but also disadvantages (cons) of ePROMs are sum-
marized in Table 15.2.

Table 15.2 Advantages (pros) and disadvantages (cons) for ePROMs (adapted from Schick-
Makaroff) [ 93 ]

PROs CONs

Real-time assessments with immediate access to the

data and scoring

Need for IT system that might be

costly

Rapid, time-saving Validation studies necessary

Facilitate the immediate patient–physician

communication

Integration in workfl ow need

effort

Data entry by the patients themselves Necessity of training of clinical

staff and patients

Reduces human-dependent steps in data acquisition Technical problems might lead

to loss of data

Improved data quality by prevention of data entry

errors

Linkage to EHR might need

programming

More valid data Users’ resistance to technology

View of long-term follow-up data at a glance Regular adoptions to software

updates necessary

Depending on the system: use of different devices

Link to electronic health records/patient

documentation systems allowed

Batched, stamped, and real-time data transactions

Cost-effi ciency in the long-term

Automated alerts when problems are identifi ed

Patient and physician satisfaction

PROs can be tailored to patient’s specifi c needs

Facilitate patient management in care transitions

IT information technology, EHR electronic health records, PROs patient-reported outcomes

J. Richter et al.