Dr. Newman traces the seeds of RheumPACER back to 1988, when he developed a paper-based questionnaire and outcomes database. But he had to wait for the right technology—and the right colleagues—to make a system like RheumPACER possible.
He and his team received a grant to fund the project from the Agency for Healthcare Research and Quality three years ago.
“That was the final piece that could get the momentum going,” Dr. Newman says.
A review found that after two years, 6,275 return patients had completed 19,876 touch-screen questionnaires. Eighty-six percent of RA patients had completed a Routine Assessment of Patient Index Data 3 (RAPID3); a Clinical Disease Activity Index (CDAI) had been completed for 61% of patients.
RheumPACER is being used by 12 of 14 doctors in the two Geisinger departments where it is available.
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Physician and Patient Feedback
Virginia Lerch, MPH, a research development manager at Geisinger’s Henry Hood Center for Health Research and the RheumPACER project manager, said the reaction from doctors has been mainly positive.
“All in all, they’ve been a really supportive group,” she says. “They’ve really embraced the innovation. They’ve provided a lot of the changes that we’re doing. This next round of revisions has come from their feedback.”
William Ayoub, MD, director of rheumatology at the Geisinger location in State College, Pa., who works at a site that uses the system as well as one that doesn’t, says it involves extra work for the patient and the doctor. But, he believes that it’s work that pays off.
“The advantage is we’re able to objectively measure how well the patient may be doing,” he says. “I would say that little extra work is probably well worth it. It makes us better able to document the patient’s status, enter it into the medical record, and follow it in time.”
He said that a “distinct minority” of patients is “computer phobic” and is reluctant to do the questionnaire, but most grow accustomed to it.
“If we explain to the patient how this helps us to care for them, and if we show them some of the nice graphs that PACER generates, they’re able to say, ‘Oh, this is important,’ and the patients are very willing to complete the PACER questionnaire,” he notes.
