PROM Collection Software for Orthopedic Practices (2026)
PROM collection software for an orthopedic practice collects validated patient-reported outcome measures (HOOS Jr for hips, KOOS Jr for knees, plus the general health and pain items CMS requires) before surgery and again at the required post-op interval, matches each post-op score to its pre-op baseline, chases non-responders by phone and text until the capture rate clears the reporting threshold, and exports the matched pairs with timestamps to the registry or the hospital's quality team. The instrument is standardized. The work is the chasing. In 2026 that work has a number attached: a 50 percent matched-pair threshold for hospitals, and 45 percent for ASCs once outpatient reporting becomes mandatory.
This guide covers which measures and windows the CMS THA/TKA PRO-PM requires, why capture rate rather than survey design decides whether a site clears the threshold, how collection differs for an orthopedic group with an attached ASC, and where a conversation-based approach fits.
Key Takeaways
- The THA/TKA PRO-PM requires a pre-op score within 90 days of surgery and a post-op score 300 to 425 days after it, and only matched pairs count.
- Hospitals must reach 50 percent data completeness under the inpatient program, and ASCs face a 45 percent threshold once outpatient reporting becomes mandatory.
- Only 3.5 percent of eligible hospitals submitted data during the voluntary period, so most orthopedic programs have not yet built the collection operation.
- More than 750 institutions now submit PROMs to the American Joint Replacement Registry, so the registry infrastructure exists; the gap is patient response at day 300.
- A phone and text conversation that is already checking in on the patient is the cheapest way to close a survey that a portal link left open.
The Data Behind the Decision
The measure is specific. Under the CMS Hospital Inpatient Quality Reporting program, hospitals must submit pre- and post-operative patient-reported outcome data for at least 50 percent of eligible elective primary hip and knee replacement patients, and a hospital that fails to comply faces reduced payment on all Medicare fee-for-service Part A claims, not only orthopedic ones (Health Affairs Scholar, 2025). The same analysis found that only 101 of 2,920 eligible hospitals (3.5 percent) participated in the voluntary reporting period, and that among hospitals selected for the TEAM model, 28 of 706 did.
The outpatient side follows. CMS adopted the THA/TKA PRO-PM for hospital outpatient departments and ASCs in the CY 2025 OPPS and ASC final rule, with voluntary reporting for the 2025 through 2027 reporting periods and mandatory reporting beginning in 2028. Hospital outpatient departments must submit matched data for at least 50 percent of eligible procedures and ASCs for at least 45 percent. The pre-op window runs from 90 to 0 days before surgery and the post-op window from 300 to 425 days after. Success is defined as a 22 point improvement on HOOS Jr for hips or 20 points on KOOS Jr for knees (Code Technology summary of the CMS final rule, 2024).
The registry side is further along. The 2025 American Joint Replacement Registry annual report counts 4.6 million procedures, more than 750 institutions actively submitting PROM data, and 107 ASCs under contract (Arthroplasty Today, 2026). The bundle context is now live as well: the TEAM model started January 1, 2026, is mandatory for about 720 hospitals, and covers lower extremity joint replacement episodes for 30 days after discharge with payment adjusted for quality performance (CMS, 2026). And 82% of patients try to book care outside a practice's regular office hours; the patient who books at 8 p.m. answers a survey at 8 p.m., not during the workday when your MA is calling.
What does PROM collection software actually do?
Four things. It identifies eligible patients from the surgical schedule and stamps the windows on each one. It administers the instrument the patient is due for, without altering the validated wording, and stores the score with the date. It follows up with non-responders on a schedule and switches channel when one fails: a text link unopened for a week becomes a phone call that reads the KOOS Jr items aloud and records the answers. And it reports, per surgeon and site, eligible patients, baselines captured, matched post-op scores, and distance from the 50 or 45 percent threshold.
The hard part is the post-op window. A patient at day 300 has usually been discharged from the practice for months. They are not on the schedule, so there is no visit to attach the survey to. Software that only sends a portal link at that point produces a low response rate, and a low response rate at 300 to 425 days is what breaks the matched-pair math.
How is PROM collection different in orthopedics?
The instruments are short. HOOS Jr and KOOS Jr each take a few minutes and produce a single score, which is why they can be administered by voice as well as by link. The episode is not short: baseline before surgery, the operation at the hospital or ASC, the six-week and three-month visits, then a long quiet stretch until day 300.
Systems. The surgical schedule lives in Epic, athenahealth, ModMed, or NextGen for the orthopedic practice and in HST or a comparable system for the ASC. Phreesia may already push a pre-op questionnaire at check-in, which handles the baseline for the patient who has a pre-op visit inside the 90-day window, but it does nothing at day 300. The collection tool has to read the procedure date from wherever it is and hold the patient's identity across both settings, because the same surgeon does hips at the hospital on Tuesday and at the ASC on Thursday.
Payers and reporting. Hospital-based joints flow into the inpatient measure and, at TEAM hospitals, into bundle quality performance. ASC joints flow into the ASC quality program and the registry. A group that reports through the hospital, the ASC, and the AJRR needs one source of truth for matched pairs, not three spreadsheets.
What should PROM collection software cost and connect to?
It should connect to the surgical schedule, the practice management system for demographics and contact preferences, and the registry or quality team's export format. Pricing usually follows provider count or site count rather than surveys sent. The cost comparison that matters is staff time: an MA calling non-responders at day 300 spends most of the hour on voicemail. If the practice already runs monthly check-ins between visits, the survey is one more question in a conversation that is already happening.
How to build PROM collection in an orthopedic practice: 6 steps
- Define the eligible population. Elective primary THA and TKA by surgeon and site, with the measure's exclusions applied, pulled from the schedule weekly.
- Capture the baseline inside the 90-day window. Attach it to the pre-op visit where one exists; reach the rest by text or call before the surgery date.
- Schedule the post-op window on the day of surgery. Day 300 through day 425 goes on the calendar from day zero, with the patient's preferred channel recorded.
- Chase in two channels. Text first, then a call that administers the instrument verbatim, then a second attempt in each, with every attempt logged.
- Report matched pairs weekly. Eligible, baseline captured, post-op captured, matched, and percent to threshold, by surgeon and by site.
- Feed the result back to the surgeon. Improvement against the 22 and 20 point benchmarks is a clinical conversation, not only a compliance number.
What Should Still Go to a Human?
Interpretation. A KOOS Jr score that dropped between six months and a year is a clinical signal, and the surgeon or PA decides what to do about it. A patient who reports new pain, instability, or a fall while answering a survey gets a human call, not a thank-you message. Registry data quality questions and any dispute over what the hospital or ASC owes under a quality adjustment stay with the quality and revenue cycle teams.
Where Clinekt Fits
Clinekt is not a scheduling tool and not an AI receptionist company. Clinekt is the patient activation platform for specialty practices: four AI agents that share one memory of every patient and cover the whole journey, from first click to the care between visits. PROM capture is one of the jobs the Care Management Agent does between visits: it collects validated outcome surveys such as HOOS Jr and KOOS Jr by call or text, flags concerning answers to staff, and logs consent, care plans, and minutes so the biller can bill from the audit trail through the normal process. It was built for the care programs Medicare already pays for and for bundle-era engagement scoring. Because all four agents share one memory through Clinekt OS, the patient who arrived through the website in spring is recognized when they answer a KOOS Jr text in winter, and the patient whose one-year visit was never scheduled is found by the Recall Agent (see orthopedic patient recall software) rather than counted as care leakage.
Deployment is live the same day, with no IT project and no new staff workflow, and it syncs to the EHR. The platform is HIPAA compliant and SOC 2 Type II. The published result is on the front end of the journey: Baldwin Bone & Joint, an orthopedic group, generated 263 qualified surgical leads and 159 booked appointments, a 60% booking rate, in a single quarter (detail in orthopedic patient activation results), and more than one million patient interactions have been completed across the platform. Size the gap with the leakage calculator, or book a demo.
Frequently Asked Questions
Which PROMs does CMS require for hip and knee replacement?
The THA/TKA PRO-PM uses HOOS Jr for hips and KOOS Jr for knees, plus PROMIS Global or the VR-12 mental health items, a single-item health literacy screen, and pain items. The wording of the validated instruments cannot be changed.
When do the pre-op and post-op surveys have to be collected?
The pre-op score must be captured in the 90 days before surgery and the post-op score 300 to 425 days after it. Only patients with both scores count toward the completeness calculation. Capturing a baseline and missing the post-op window earns nothing.
What capture rate does an orthopedic practice need?
Hospitals under the inpatient program must submit matched data for at least 50 percent of eligible patients. Under the outpatient rule, hospital outpatient departments face the same 50 percent threshold and ASCs face 45 percent once mandatory reporting begins.
Can PROMs be collected by phone?
Yes, if the instrument is administered verbatim and scored and stored the same way as a written response. Phone administration matters most at day 300, when the patient has no visit scheduled and a text link may go unopened.
Does PROM collection help with surgical bundles?
It does at TEAM hospitals, where quality performance affects the payment adjustment on lower extremity joint replacement episodes that started January 1, 2026. The matched pre-op and post-op scores are the outcome evidence, and the logged outreach is the engagement evidence. Both come from the same collection operation.
Put your annual joint volume into the leakage calculator to see what an unreached patient is worth across the episode, then book a demo to hear the Care Management Agent administer a KOOS Jr by phone.