Implementation of cliexa-RA digital platform improved patient experience and time efficiency for 300 rheumatoid arthritis patients.

BackgroundResearch supporting the use of digital platforms to increase efficiency in clinical settings has emerged and yet implementation remains a challenge. This can be explained by the unique needs of clinics for data collection and electronic medical record integration. ObjectiveTo identify how screening and monitoring of Rheumatoid Arthritis patients through a customized electronic platform, cliexa-RA impacts patient experience, physician experience, cost of care, and population health based on the Institute for Healthcare Improvements quadruple aim. Methodscliexa-RA was delivered on three tablets at the Colorado Arthritis Center over a six-month period to patients and physicians, who were asked to complete a 16-question intake form allowing patients to score their ability to complete daily tasks using the RAPID3 scoring system, and a six-question patient engagement survey. The physician would then input 28 joint assessment scores following a physical examination. cliexa-RA would then calculate five disease state scores, DAS28 (ESR), DAS28 (CRP), SDAI, CDAI, RAPID3, and send an EMR-compatible PDF file. ResultsTime stamp and patient satisfaction data was collected on 300 patients. Patient intake forms and self-reporting took an average of 2.4 minutes, and clinic-reported time required for calculation and transcription of the data using cliexa-RA was 1 minute with an additional 10 second direct data integration to the EMR after form submission. Eighty-five percent of patients said they would recommend cliexa forms to other clinicians. cliexa-RA scored an average of 3.57 out of 4 when compared to paper in ease of use, 3.61 in patient-reported reduction of time spent, and 3.50 when asked how easy the platform was to understand. Overall patient satisfaction was scored at 3.55 out of 4 and physician experience was measured by the adoption of the program in the study clinic with full integration into the Greenway Health EMR (currently integration is pending). Cost of care and population health impacts were not immediately available as a result of the pilot study; however, numerous savings and improvement opportunities exist as a result of cliexa-RA implementation. ConclusionPatient experience and physician engagement had immediate positive impacts from the implementation of cliexa-RA. Cost of care opportunities exist in both time savings and annual Medicare reporting costs. Population health opportunities exist in the collection of patient data, increasing informed decision making by physicians, as well as in the potential for future RA research using this data.