For orthopedic leaders, conversations about PROMs often revolve around compliance. How are we going to collect the surveys? Can we meet CMS requirements? Who on the team is responsible for following up with patients months after surgery? Those questions are important, but they can also narrow the discussion. Once the focus shifts to reporting requirements, it's easy to think of PROMs as another administrative task that needs to be completed.
Lauren Cerqua came to the process from a different direction. As Director of the Orthopedic Service Line at St. Clair Health, she was certainly aware of the financial implications of CMS reporting. Her team had calculated what missing the requirements could mean for an independent community hospital, and the potential reduction in Medicare reimbursement was significant. More importantly, she knew the existing process depended too heavily on manual work, and there wasn't a realistic path to sustaining it as reporting requirements continued to expand.
"We cannot be doing this manually and risk that huge financial penalty."
During a recent fireside chat hosted by Force Therapeutics, Cerqua described evaluating several vendors that could collect PROMs. As those conversations progressed, however, her team found themselves spending less time comparing survey functionality and more time thinking about patients. What information should patients receive before surgery? How could they stay connected during recovery? Would a patient still feel engaged one year after leaving the hospital, or would the next interaction simply be another request to complete a survey? That changed the way St. Clair approached the evaluation process.
Looking Beyond PROMs Collection
Cerqua recalled that several platforms on the market could satisfy the organization's immediate reporting needs. What distinguished one solution from another wasn't the ability to administer questionnaires. It was the experience surrounding them.
"Force just really stood out in what extra capabilities [beyond PROMs] it had available to it…Force's messaging service really stood out as far above and beyond the other applications that we were looking at…[and another] piece that really stood out was the support of the Force team. That was very helpful."
She described wanting a platform that could support patients throughout the entire episode of care rather than appearing only when data needed to be collected. Educational content before surgery, reminders during recovery, and ongoing communication all contributed to a more consistent experience for patients while making PROMs collection feel like one part of a larger relationship instead of an isolated task.
One comment from Cerqua captured that philosophy particularly well.
"We wanted to make sure that we had something that could really wrap the patient in a hug with information and how we cared for them as they move through the entire process of having a hip replacement or a knee replacement."
Throughout the discussion, she returned repeatedly to the patient experience rather than the technology itself. PROMs collection was important because CMS required it, but she consistently framed the broader goal as helping patients feel informed and supported from the time surgery was scheduled until long after recovery.
Implementing New Technology Without Disrupting Clinical Workflows
One part of Cerqua's story that may sound familiar to other orthopedic leaders is that implementation depended less on building new workflows than on adapting existing ones.
St. Clair already had established clinical pathways for joint replacement. The work involved translating those processes into the platform, tailoring educational content for different surgeons, coordinating with IT, and giving staff enough time to become comfortable with the new way of working. Weekly meetings with the Force implementation team created space to answer questions, troubleshoot issues, and refine workflows as the rollout progressed.
Looking back, Cerqua estimated that it took about two months before the team felt settled into the platform and had developed routines for tracking PROMs, identifying missing surveys, and organizing follow-up work.
That adjustment period wasn't presented as a setback. It was simply part of introducing a new system into a busy clinical environment, where the goal is rarely to change everything at once. Instead, the platform gradually became part of the team's existing operations.
Why Patient Education Influences PROM Completion
Cerqua also offered an observation that extends beyond orthopedic care.
Healthcare organizations ask patients to complete surveys constantly. Physician offices send them. Hospitals send them. Health plans send them. Patients often have little reason to distinguish between a satisfaction survey and a PROM unless someone explains the difference.
"Patients don't really understand why they are getting bombarded with surveys from all different directions," she said. "We try to explain to them that the PROMs are a little different...It's how all of our systems are going to be able to demonstrate the quality of care and the efficiency that we're able to provide the patient."
That explanation becomes particularly important at the one-year follow-up, where organizations are expected to collect matched PROMs within specific CMS timeframes. Cerqua noted that preoperative surveys are generally easier to obtain. Maintaining engagement for a full year requires more intentional communication, especially if patients are expected to recognize why another survey matters months after surgery.
Her team's approach has been to introduce that conversation early, remind patients throughout recovery what to expect, and use the platform's ongoing communication to reinforce those expectations over time.
Preparing for the Direction Healthcare Is Already Moving
Toward the end of the discussion, Cerqua reflected on the broader trend shaping orthopedic care.
"Outcomes are coming. They're here. So more and more payers are going to be tying reimbursement to outcomes."
She expects CMS initiatives such as the THA/TKA PRO-PM, TEAM, and CJR-X to continue influencing how orthopedic programs are evaluated, with commercial payers likely following a similar direction. From her perspective, collecting outcomes data and maintaining long-term patient engagement are becoming routine operational responsibilities rather than temporary regulatory projects.
That perspective also explains why St. Clair invested in a platform designed around the entire episode of care. PROMs collection was the immediate need, but Cerqua's team viewed it as one component of a broader shift toward continuous patient engagement, longitudinal outcomes tracking, and more consistent communication throughout recovery.
For orthopedic leaders facing similar decisions, St. Clair's experience offers a useful reminder that technology evaluations often become conversations about care delivery. The reporting requirements may create the initial urgency, but the longer-term value often comes from building processes that patients and clinical teams can sustain as expectations continue to evolve.
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