Background
Solomon et al. examined whether a mobile application (app) integrated into the electronic health record (EHR) would be used by patients and rheumatologists and could reduce the volume of in-person rheumatologist visits for patients with rheumatoid arthritis (RA). The app collected patient-reported outcomes (PROs) between visits, processed the data, integrated the PRO information into the EHR for rheumatologists, and suggested early or delayed visits based on the PRO data.
Methods
The researchers developed an app that prompted patients to complete brief validated PRO questionnaires, concerning pain, fatigue, function and disease activity. A total of 150 patients with RA used the app, and they were matched with patients who had RA but did not use the app. The app results were integrated into the EHR. Rheumatologists then received messages based on the PROs, recommending the patient receive a visit earlier or later than scheduled.
Of the 150 patients with RA who used the app, 83% were women, 7% had been diagnosed just two years before or less, and 50% were seropositive. Their median age was 62 years. Controls had very similar characteristics.
Results
The app suggested delayed visits 108 times and early visits 31 times during the year-long study period in the 150 app users. In the year before participants used the app, the median volume of monthly rheumatologist visits was 31.2 compared with 30.4 for patients in the control group. During the study year in which the app was used, patients’ median number of visits per month was 36.8 compared with 38.7 in the control group. This difference was not statistically significant. No differences were noted in flare rates or visit delays.
Conclusion
In this initial trial of an application intended to improve visit efficiency, Solomon et al. found that an integrated PRO app was feasible in clinical practice, but produced no reduction in visit volume in this first study. Use of the app outside an academic medical center will be pursued.
For complete details, including source material, refer to the full study.
Excerpted and adapted from:
Solomon DH, Altwies H, Santacroce L, et al. A mobile health application integrated in the electronic health record for rheumatoid arthritis patient-reported outcomes: A controlled interrupted time-series analysis of impact on visit efficiency. Arthritis Rheumatol. 2024 May;76(5):
