A proposal for standardized PREMs implementation in hospital context in Portugal

Abstract

Patient Reported Experience Measures (PREMs) are essential tools to assess healthcare quality from the patients' perspective, complementing traditional outcome-based evaluations. In Portugal, although healthcare institutions are required to conduct satisfaction surveys, the lack of standardized and interoperable PREMs limits comparability and benchmarking. This paper proposes a framework for the standardized implementation of PREMs in hospitals, supported by interoperability through the HL7 FHIR standard. The solution integrates with hospital information systems to automatically identify clinical encounters, distribute tailored questionnaires, ensure anonymized data collection, and provide real-time analytics through a dashboard with alert mechanisms. The framework was validated in a simulated environment, demonstrating full automation of survey distribution and response analysis, while ensuring patient privacy and usability for healthcare staff. Results indicate that interoperability is a strategic enabler for scalable and sustainable PREMs adoption, fostering continuous quality improvement in healthcare services. Limitations and future work include testing with real hospital systems, expanding to additional clinical contexts, and scaling to national benchmarking.