The Agency for Clinical Innovation (ACI) is leading the co-design, testing, refinement and implementation of Patient Reported Measures (PRMs) across NSW. The journey of co-designing a PRMs program began in 2014 to better understand what would the collection and use of outcomes and experiences that matter to people (our patients, carers) look like and how the information could be captured in real-time and presented back to clinicians in real-time to inform shared-decision making and get a true indication of symptom burden and impact of care and treatment from a persons perspective. Whilst there was academic literature and small pockets of excellence locally and internationally we could not find a systems wide approach for collecting and using PRMs in real-time at the individual, service and system levels across cohorts, populations and the care continuum. Today (2021) we continue to take an iterative and co-design approach to inform the PRM program inclusive of the technology platform enabling real-time capture and use of outcomes and experiences that matter to patients: Health Outcomes and Patient Experience (HOPE) platform. HOPE was co-designed based on previous technology used and lessons learnt, informing a state-wide scalable technology platform to demonstrate value to our patients, carers, clinicians and key stakeholders across NSW.