McGrail and colleagues have made a strong case for embedding PROMs into the everyday healthcare system. This commentary focuses on translating their argument into policy and practice. PROMs can no longer be considered a "nice to have"; they are core elements of a patient-centred, quality-oriented healthcare system. Putting PROMs at the centre of the health information agenda signals a major shift in the orientation of the system. Their development should be mandatory, and they should be used to support quality improvement, accountability, and clinical practice redesign, particularly in primary care.