Beyond the EMR: Automating PROMs Capture and Post-Discharge Protocols to Protect Staff Capacity and CMS Compliance
- SolvEdge
- Nov 17, 2025
- 6 mins read
In orthopedic groups, ambulatory surgery centers (ASCs), and multi-site specialty practices, the transition from surgical volume to value-based reimbursement hinges on two non-negotiable metrics: reliable Patient-Reported Outcome Measures (PROMs) capture and airtight post-discharge protocol adherence. Yet most organizations still depend on EMR-centric workarounds and manual staff intervention—exposing them to MIPS penalties, staff burnout, and preventable readmissions.
SolvEdge changes the equation with Orthopedic PROMs Automation and Digital Care Pathways that operate outside the EMR, enforcing clinical rigor at scale while removing 80–90% of the operational lift from nurses and coordinators.
The Hidden Cost of Manual Protocol Management
Orthopedic practices face a perfect storm of compliance and capacity pressures:
PROMs capture rates below 60% in most athenaOne-dependent groups, triggering CMS MIPS composite score deductions of 3–9 points.
Post-discharge protocols that require 7–14 touchpoints (wound checks, pain titration, DVT prophylaxis) but achieve <70% completion when managed manually.
Staff burnout from repetitive outreach: coordinators spend 2–3 hours per case on phone calls, faxes, and portal messages—time diverted from revenue-generating activities.
EMR limitations in athenaOne, Epic, and Cerner that treat patient engagement as an afterthought, forcing risky workarounds (scanned PDFs, flagged tasks, duplicate documentation).
These gaps are not theoretical. A 2024 AAOS registry analysis showed practices with <75% PROMs completion faced $87,000 average annual MIPS penalties per 10 surgeons.
Why EMRs Alone Cannot Solve Patient Engagement
EMRs excel at documentation, not orchestration. Key architectural failures include:
| EMR Limitation | Clinical Impact |
|---|---|
| No native multi-channel sequencing (SMS → IVR → portal) | Patients ignore portal-only prompts; capture drops 40%. |
| Inability to enforce conditional logic (e.g., escalate if pain > 7) | Risk stratification delayed until next clinic visit. |
| Task-based workflows requiring staff assignment | Protocols stall when coordinators are overloaded. |
| PROMs stored as unstructured attachments | Data unusable for risk-adjusted outcomes reporting. |
Competitors like Phreesia and Well Health bolt front-end check-in tools onto the EMR, but stop short of Post-Discharge Protocol Adherence. Force Therapeutics and Notable offer episode-based pathways—yet require per-patient configuration and still lean on staff for exception handling.
SolvEdge’s Automated Solution: RecoveryCOACH and Fail-Safe Digital Pathways
SolvEdge deploys CMS Compliance Automation through a zero-code rules engine that lives parallel to the EMR, not inside it.
Core Automation Capabilities
Patient Engagement Automation: Multi-modal outreach (SMS, email, IVR, app) with read-receipt tracking and automatic escalation.
Proactive Risk Stratification: Real-time scoring of PROMs responses (e.g., KOOS-JR <50 → flag for PT non-response) triggers protocol branches without staff input.
Fail-Safe Adherence Mechanisms:
Auto-resend unanswered surveys at 24/72 hours.
Lock progression until mandatory milestones (e.g., DVT education quiz) are completed.
Auto-generate compliance attestations for MIPS audit trails.
EMR Workflow Optimization: Bi-directional HL7 interfaces push structured PROMs data into athenaOne as discrete fields—no scanning, no duplicate entry.
Configurability Without Complexity
Orthopedic groups tailor pathways in <30 minutes:
1. Select episode (THA, TKA, rotator cuff, ACL).
2. Adjust touchpoint cadence and risk thresholds.
3. Map data fields to athenaOne flowsheets.
No IT tickets. No per-surgeon customization.
Competitive Landscape: Depth of Automation Matters
| Feature | SolvEdge | Promptly | Force | Phreesia | Well Health | Notable |
|---|---|---|---|---|---|---|
| Orthopedic PROMs Automation beyond check-in | Yes | No | Partial | No | No | Partial |
| Digital Care Pathways with conditional logic | Yes | No | Yes | No | No | Yes |
| Post-Discharge Protocol Adherence enforcement | 95%+ | <70% | 80% | N/A | N/A | 75% |
| Zero-staff exception handling | Yes | No | No | No | No | No |
| Structured PROMs → athenaOne discrete fields | Yes | No | No | No | No | No |
| MIPS audit-ready attestations | Auto | Manual | Manual | N/A | N/A | Partial |
SolvEdge internal data, 2025; competitor claims per public case studies.
Real-World Outcomes: Measurable ROI in 90 Days
A 12-surgeon orthopedic group using SolvEdge achieved:
PROMs capture rate: 42% → 93% (KOOS-JR, HOOS-JR, VR-12).
Staff time saved: 2.4 FTEs redirected from outreach to prior authorizations.
MIPS composite score: +7.2 points → $114,000 bonus.
Readmission risk alerts: 41 early escalations; 12 preventable admissions avoided.
ASC protocol compliance: 98% for TJRR bundle metrics.
“We stopped playing phone tag. RecoveryCOACH became the coordinator we couldn’t hire.” — Practice Administrator, Midwest Orthopedic Institute
Take Control of Compliance and Capacity
Orthopedic groups can no longer afford EMR workarounds that drain staff and jeopardize reimbursement. SolvEdge’s Orthopedic PROMs Automation and CMS Compliance Automation deliver:
90%+ PROMs capture without staff chase.
Digitally enforced Post-Discharge Protocol Adherence.
Risk-adjusted outcomes data flowing seamlessly into athenaOne.
Scalable across 1 site or 50.
Ready to Fix Your PROMs Gaps?
Schedule a 15-minute workflow audit to map your current PROMs gaps and calculate the exact ROI.
