Martin Bergman, MD, a rheumatologist in private practice in Ridley Park, Penn., has office staff give patients a Routine Assessment of Patient Index Data (RAPID) questionnaire while they are in the waiting room. He then scores the questionnaire before meeting with the patient.
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Explore This IssueOctober 2007
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Computers facilitate data collection and analysis for some physicians. For example, David Fraser, MD, a rheumatologist at Coastal Arthritis and Rheumatism in Jacksonville, N.C., plans to have a computerized touch screen in the waiting room on which patients can complete a mini-HAQ. The computer will print out an assessment score, which Dr. Fraser or an administrator will record in the patient’s chart or manually input into the electronic medical record (EMR).
Dr. Fraser also finds computerized tools valuable in scoring and analyzing information. He uses an online calculator (www.das-score.nl) – developed by the Department of Rheumatology at the University Medicine Center of Nijmegen in the Netherlands – for scoring the DAS-28CRP.
For office use, he analyzes trends in DAS-28CRP and mini-HAQ data through his EMR. By using a spreadsheet program such as Excel, he can easily transfer EMR data to other software for statistical analysis when writing papers and abstracts or comparing one drug or patient subset with another.
One day, Dr. Fraser hopes to use a tablet PC to input and calculate DAS-28CRP data in the exam room. These data, in addition to mini-HAQ data captured by touch screen, would directly flow into the patient’s EMR.
While computers may help collect and analyze data, a paper-based system may be preferable, says Theodore Pincus, MD, professor of medicine in the rheumatology division at Vanderbilt University in Nashville, Tenn.
He keeps hard-copy records of patients’ multidimensional HAQ scores rather than entering data into an EMR. “If you have the patient’s chart, X-rays, lab reports, and outcomes measures all up on the computer, you have to scroll back and forth between four documents,” he explains. “Having a hard copy and spreading results out on a table is easier.”
Paper records can be as effective as electronic records if the practice uses standardized data forms and dictation templates, says Dr. Harrington, adding that switching to an EMR may not be realistic for many offices in the short term.
Whether the record is paper or computer based, Dr. Harrington advises that practices enter all their patient information into a registry built on diagnostic billing codes, organize clinical data in a standardized format, and monitor any quantitative measure that reflects active RA joint inflammation.