PREM & PROM: The Silent Revolution Transforming Patient Care in the Middle East
When I first entered the healthcare space a decade ago, Middle Eastern organizations measured success by efficiency - how fast beds turned over and how short stays were. But here’s the hard truth: A patient could leave the hospital ‘on time' yet still struggle to walk, work, or even sleep.
A surgery might go well on paper, but if it doesn’t improve a patient’s quality of life, can we truly call the procedure a success? Today, we’re finally asking the right question: Did care actually improve their life?
This shift in perspective is driving the adoption of new approaches to bring patients to the center of care. Two frameworks- PREM (Patient-Reported Experience Measures) and PROM (Patient-Reported Outcome Measures) are rewriting the narrative in the Middle East.
Across the region, governments and hospitals are embracing these metrics to focus on what truly matters for patients- their experience and how their quality of life improves after treatment/surgery. Together, these metrics are shaping what “quality” really means in healthcare.
Let’s explore how PREM (Patient-Reported Experience Measures) and PROM (Patient-Reported Outcome Measures) are revolutionizing healthcare in the Middle East.
PREM+PROM: A Synergistic Duo
PREM is about how care is delivered. PROM is about what impact that care had. You can think of them as two sides of the same coin.
For example, PREM may ask a patient, “How long did you wait before seeing your doctor?”. Such objective evaluations help to document the patient’s first-hand experience while receiving care.
On the other hand, PROM assesses a patient’s quality of life after a treatment or surgery. It usually has questions like "How would you rate your ability to perform daily activities? This helps us understand the holistic impact of an intervention on a patient’s health, a much better measure than traditional metrics.
When used in isolation, they only tell us a part of a patient’s story. A patient may report excellent communication with the hospital staff (PREM) but may still suffer from symptoms after treatment. However, when we implement PREMs and PROMs together, they offer a 360-degree view of care quality.
As I see it, this synergy is especially important in systems transitioning to value-based care where patient outcomes and patient satisfaction are both key performance indicators. For example, a hospital can track if improving bedside communication (PREM) can lead to better and faster recovery (PROM), thereby linking experience and outcome.
Together, PREM and PROM form a feedback loop that provides actionable insights for policymakers, administrators, and providers, thereby improving patient-centric care.
Getting the Most Out of PREM & PROM: What Actually Works
Now, the real question is how do we harness the potential of this duo? Based on my experience, here are some valuable strategies:
- Train healthcare staff: It is crucial to train staff members on how to interpret PREM/PROM data and implement the required changes. Organizations must introduce continuous learning opportunities that can help providers integrate patient-reported outcomes into daily clinical decision-making.
- Engage stakeholders: To ensure that PREM and PROM programs are relevant, organizations must think about involving patients and providers in the planning phase from the get-go.
- Address barriers to adoption: Several barriers such as limited time or workflow disruption that discourage the adoption of PREM/PROM should be addressed. Organizations must think about customizing their workflows and providing ample resources for better adoption.
- Leverage technology for efficiency: Organizations must try to integrate PROM and PREM into clinical workflows or electronic health records (EHRs) for better data collection, analysis, and decision-making.
- Harness the power of AI: Leveraging artificial intelligence will allow organizations to analyze large volumes of PREM and PROM data to identify high-risk patients and provide personalized care. Tools that harness AI can also flag anomalies and provide actionable insights to care teams.
Challenges Along the Way
Of course, the path to implementing PREM and PROM isn’t without roadblocks. I have personally seen organizations struggling to see the big picture because of data silos.
Each department might collect data differently—or not at all.
There’s also the technological gap. Not every hospital has the necessary digital infrastructure to collect and interpret feedback in real-time. This is where AI could really help, but we’re not quite there yet in many parts of the region.
Another issue is health literacy. Patients may struggle to understand what’s being asked of them. If we want genuine feedback, we need to make sure patients feel comfortable, not overwhelmed.
Middle East’s Real-World Success Stories with PREM & PROM
When it comes to leading patient-reported measures in the Middle East, Saudi Arabia is the first country in the region that comes to the top of my mind. Under Vision 2030, the Kingdom has integrated PROMs into its value-based healthcare strategy, directly incorporating them into national KPIs.
Saudi Arabia’s Vision 2030 is leading the charge, but this isn’t just policy. It’s a fundamental shift:
Before: “Was the surgery complication-free?”
Now: “Can the patient play with their kids again?”
Through a strategic partnership between the Council of Health Insurance (CHI) and the Center for Improving Value in Health, Saudi Arabia has built a robust PROMs framework focused on four high-impact areas: cataract surgery, bariatric surgery, pregnancy & childbirth, and diabetes. By combining generic tools like PROMIS-10 with condition-specific metrics, they’re capturing both broad and precise patient insights.
The country is implementing a phased rollout. They are starting with a pilot program and then scaling it gradually across the country. This shows us what is actually possible when patient voice is systematically scaled to drive better outcomes.
My View: It’s Time Patients Defined Success
As someone who has spent a lot of time understanding the complexities of the evolving Middle Eastern healthcare landscape, I genuinely believe that PREM and PROM will help us build a more empathetic and humane healthcare system. We’re doing a lot right like building world-class hospitals, embracing AI, moving towards value-based care systems, and creating a global reputation for high-quality care. But, to truly elevate our healthcare delivery, we need to listen more intentionally to patients. PREM and PROM will help us do that. Because, if we don’t include a patient's voice, we’re not truly transforming care.
So I ask myself, and I ask you—are we ready to listen?
This post was originally published in Nabd-e-Ibtikar-e-Sehat- See the industry’s most advanced decision support system
Akhter Hemayoun Mubarki
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