About

The award-winning PRISM (PROMIS Reporting and Insight System from Minnesota) is an application that enhances the quality of clinical discussion between healthcare providers and patients by allowing for PRO collection and continued patient engagement outside of the clinical setting.

PRISM was developed by a multi-disciplinary team including Perk Health, a digital health design and development company, and faculty, staff, alumni and physicians from the University of Minnesota (Carlson School/MILI, CTSI/Institute for Health Informatics, School of Medicine), along with Fairview/HealthEast's Kidney Stone Institute, and consultant Elisha Friesema.

"This app is an innovative tool that will advance value- and person-centered care by ensuring that information generated by patients is a major driver in their care,” said AHRQ Director Gopal Khanna, MBA. "PRISM will help overcome challenges in collecting and integrating standardized PRO data into health information technology systems." https://www.ahrq.gov/news/newsroom/press-releases/stepup-app-phase2-winners.html

The code posted here represents the first version of PRISM that was implemented at MedStar Health as a result of winning the grand prize in AHRQ's Step-Up App challenge. This app is continually being enhanced in functionality and interoperability by the PRISM Team.

Developer Links

The PRISM App consists of a Frontend Hybrid mobile app built using Angular and Ionic and Backend built AWS Lambda and other services. To get up and running with the project, please fully install the Backend before moving on to Frontend. The Frontend configuration depends on the backend.

Important Files:

• Frontend Readme
• Backend Readme
• Install Backend Dependencies
• Run backend for development
• Deploy backend to Production

For technical and design questions please contact [email protected]

Features

Patient-Facing App for Patient Reported Outcome (PRO) Collection

PRISM provides a simple and highly usable way for patients to complete Patient Reported Outcome (PRO) surveys from a mobile app or mobile web interface including computer adaptive PROMIS measures.

Patient Engagement and Education

The app was designed to encourage patient participation through visualizations of PRO scores, population comparisons, and trends over time. The app also has a placeholder section for personalized educational materials.

Multi-Platform

PRISM includes iOS and Android apps along with mobile web interfaces through a hybrid mobile architecture.

FHIR Compliant API

PRISM uses FHIR and Smart on FHIR for interoperability and integration with an external assessment center (EAC) and the Hub.

Smart on FHIR User Management

PRISM supports Smart on FHIR for seamless integration with a user management provider including single sign on and secure authorization and authentication.

Architecture

!Include Diagram - prism, eac, hub, provider app

PRISM was built leveraging Amazon's AWS serverless products as a way to demonstrate the ability to use modern development practices in a project that mandated adherence to healthcare standards and regulations including HIPPA and FHIR. While this presented some challenges, it accelerated the initial prototype development considerably, simplified several stages of early development, and provides a useful case study.

Due to still incomplete EHR support for FHIR, PRISM was built in concert with Perk Health's Hub product which provides a means for FHIR compliant data storage, patient account creation, invitation, user sign in/on, authentication, authorization, and APIs for MedStar's provider facing app to display PRO scores within multiple EHRs.

To administer Computer Adaptive PROMIS assessments PRISM integrates with an external assessment center created by Northwestern University.

Design & Usability

PRISM underwent extensive usability testing with patients at Health East's Kidney Stone Institute. We Evaluated features including a patient's ability to complete physical function and other PROMIS measures, interact with score results and trends, peer group comparisons, relevant recommendations for follow-up actions, and education materials aimed to further engage patients in their care. These features and the app as a whole was shown to be highly usable and scored well above average on the Stsem Usability Scale for users of various level of technology literacy.

License

Link: Apache 2.0 license