Exploring the efficiency impact of mobile apps for rheumatoid arthritis care, featuring insights from Dr. Solomon. Empowering patients with Room App for symptom tracking. Study design, outcomes, and challenges of integrating mobile health app in rheumatologic care. Publication challenges and insights on becoming an editor in chief. Innovative initiatives in rheumatology journals to enhance reader engagement.
Utilizing mobile health apps for patient-reported outcomes can enhance communication between patients and clinicians in rheumatologic care.
Integrating tech-enabled decision support tools can help improve visit efficiency by prompting clinicians to review relevant patient data.
Deep dives
Development of a Mobile Health Application for Collecting Patient-Reported Outcomes
The study aimed at addressing the need for improved collection of patient-reported outcomes (PROs) between visits using a mobile health application. Developed over six years, the 'Room App' prompts patients to report on pain interference, function, fatigue, and disease activity on a frequency they prefer. The app integrates these PROs into easy-to-understand graphics for patients and provides clinicians with relevant data through the electronic health record. User-centered design principles and patient focus groups were employed to tailor the app for seamless integration into clinical workflows, aiming to enhance patient understanding and communication of symptoms.
Interventional Approach and Patient Populations in the Study
The study implemented a controlled, interrupted time series analysis focused on patients with rheumatoid arthritis, recruited from a typical RA population, including 150 patients seen at the Brigham. The 'Room App' intervention involved daily to weekly PRO questionnaires, graphical representation of longitudinal data, and clinician alerts based on patient responses. The study compared the visit efficiency outcomes and patient responses between the app users and a matched control group, highlighting the considerations made in recruitment and matching procedures.
Outcome Measures and Decision Support in Clinical Practice
Several outcome measures were assessed, including patient and provider satisfaction, visit volume, and processes of care, with a particular focus on the impact of electronic health record (EHR) prompt messages on clinical decision-making. The app's in-basket messages prompted clinicians to review PRO data, consider early visits for patients in distress, and potentially delay visits for stable patients, aiming to improve efficiency in rheumatologic care. The study's findings regarding provider responses to these messages and the balance between proactive scheduling and clinical judgment shed light on the complexities of integrating tech-enabled decision support tools in real-world practices.
Navigating Challenges and Future Directions in Digital Health Innovation
The study delves into the regulatory considerations for digital health applications, touching on the need for FDA review when transitioning to applications like remote therapeutic monitoring. The innovative use of technology in capturing and utilizing patient data between visits reveals the potential for optimizing clinical care and introducing efficiencies. The app's future trajectory involves broader dissemination to real-world practices and potential applications in remote patient monitoring, aligning with evolving healthcare reimbursement models and the broader landscape of digital health solutions.