Accepted for/Published in: JMIR Formative Research
Date Submitted: Jun 24, 2019
Date Accepted: Dec 20, 2019
Improving Quality of Care in Rheumatoid Arthritis through Mobile Patient- Reported Outcome Measurement
ABSTRACT
Background:
Background:
Patient-reported outcomes (PROs) for chronic disease management can be integrated into routine workflow by leveraging mobile technology.
Objective:
We describe our quality improvement efforts using tablets for PRO collection in a busy, academic rheumatology practice to support a treat-to-target (TTT) approach for rheumatoid arthritis (RA) management.
Methods:
Methods:
Our quality improvement team designed a process for routine collection of PROs for RA patients at the Arthritis Center, employing information technology, and the electronic medical record system. Patients received a tablet at the clinic check-in desk to complete the Routine Assessment of Patient Index Data (RAPID3) survey, a validated RA PRO. RAPID3 scores were uploaded to the electronic medical record in real-time and available for use in shared decision-making during routine office visits. Weekly data were collected on RAPID3 completion rates and shared with front desk staff and medical assistants to drive improvement. Patients in our patient family advisory council and focus groups provided informal feedback on the process.
Results:
Results:
From May 1, 2017 through January 31, 2019, 4,233 RAPID3 surveys were completed by 1,691 patients. The mean age of patients was 63 ± 14 years, with 84 % female and 83% White. Rates of RAPID3 completion increased from 16% in May 2017 to 68% by September 2017 and were sustained over time through January 2019. Informal feedback from patients was positive in terms of ease of questionnaire completion on the tablets but negative around the routine use of RAPID3 data in shared decision-making with rheumatologists during the office visit.
Conclusions:
Conclusion: We designed a sustainable and reliable process for collecting PROs from patients with RA in the waiting room and integrated these data through the electronic medical record during office visits. Clinical Trial: N/A
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