ePRO stakeholders
ePRO implementation seeks to capture and provide data that enhances the delivery of healthcare and provides a better understanding of healthcare outcomes. To achieve this important goal, stakeholder engagement is critical. Stakeholders include individuals who use and benefit from the data generated, as well as those directly involved in implementation. This page is intended to provide an orientation for conducting stakeholder engagement in the context of ePRO implementation and articulate the importance of stakeholder engagement.
Identifying stakeholders
A stakeholder is any individual or group with either a personal or a professional interest in the topic at hand (AHRQ, 2011). In the context of ePRO implementation, potential stakeholders include anyone who is interested in their development, will be involved in carrying them out, or will be affected by their application.
Related to this is the task of identifying stakeholders at different levels of the organization, from leadership to direct patient care, in order to design intervention strategies that support system-wide change (Proctor et al, 2009).
The range of potential stakeholders who should be considered part of an ePRO implementation are presented in Figure 1D. As the figure illustrates, individuals in some stakeholder groups will be directly affected by the clinical application of ePRO implementation through direct interaction with ePRO systems. For example, clinic staff may encounter altered workflows around the collection and reporting of ePROs, and clinicians and patients will interact with ePRO data as a new data source to inform shared decision-making and treatment monitoring. These stakeholders should be involved at each phase of the implementation process. However, a number of stakeholder groups are critical to the success of any implementation, and it is important to consider how and when to engage individuals across all groups.

Involving stakeholders
Seeking a range of perspectives and expertise in each phase of the implementation process helps ensure that stakeholder needs are identified and addressed. See Figure 1E for more information on how stakeholders can play a role in ePROS governance, integration, and reporting.

It is important to consider that certain stakeholders may be especially critical to the success of ePRO implementations. This is particularly true of individuals who will be directly involved in the clinical application of ePROs (e.g., patients and providers). A successful engagement strategy should aim to solicit involvement from a wide range of stakeholders with a variety of perspectives and expertise; this will ensure that those stakeholders who will be directly involved in the use of ePROs are engaged at each step of the process.
Many methodologies exist for planning and carrying out stakeholder engagement strategies. The Tools and Resources section provides additional material for Stakeholder Engagement that will guide users in developing a stakeholder engagement strategy that suits their particular needs and goals. More information about involving stakeholders in each phase of ePRO implementation can be found in the Governance, Integration, and Reporting sections of this toolkit.