“What are your thoughts on investing in technology for a rheumatology practice?” Depending on who you ask, the answer may be positive, negative or even neutral. Tech advocates will see benefits from these investments for their rheumatology practice and patients, but some see technology as an expense—time, labor and money—with little return on investment.1
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Deciding where practice revenues should be invested is no simple task. One poor decision can have a significant negative effect on a rheumatology practice, says Jeffrey Curtis, MD, MS, MPH, the William J. Koopman Endowed Professor in Rheumatology and Immunology at the University of Alabama-Birmingham. Dr. Curtis, a longtime member of the ACR’s Registries and Health IT Committee, suggests physician groups look to make tried-and-true technology investments, which may have a history of real world success.
“There is high potential for false starts, and [tech] companies that are here today [may be] gone tomorrow,” Dr. Curtis says. “There also needs to be the recognition that anyone can build an app or invent new tech, but making it useful to the relevant stakeholders, including patients, is often very challenging.”
Dr. Curtis and fellow ACR committee member Ankoor Shah, MD, agree that the one thing all rheumatologists should be investing in is advanced analytics from electronic health record (EHR) data. EHRs are the low-hanging fruit of technology investment, Dr. Curtis says, noting EHRs offer invaluable insight into quality improvement and missed reimbursement opportunities.
“The ability to easily capture, track and report quality improvement data is probably the biggest thing an EHR can do for a rheumatology practice, as a business,” says Dr. Shah, a rheumatologist at Duke University in Durham, N.C. For smaller practices, investing in EHR training for providers can [make] a big impact on accessing data to improve both billing and patient care.
“The thing that has helped me the most is having a dedicated person who I can contact to help me with a question, or even train me on how to use the EHR better,” Dr. Shah says. “A small, 15–20 minute [time] investment can actually shave minutes off of a visit—in terms of documentation—that can then add up over time to considerable time savings.”
Dr. Shah’s interest in health IT began a few years ago when Duke University joined the ACR’s Rheumatology Informatics System for Effectiveness (RISE) registry. He says clinical informatics has potential as a practice-level investment. The field has exploded in the past five years, he says, with many MDs earning advanced degrees and/or becoming dual-board certified in informatics. Some are taking positions with large healthcare and technology firms.
As Dr. Shaw points out in this excellent article by Richard Quinn, “With everyone now having a smartphone or watch, and having them on all the time, collecting those data in real time can allow rheumatologists to better tune our treatments.” In fact, there is no investment necessary if rheumatologists are seeking more real-world, patient-reported outcomes data, immediately. ArthritisPower, created by CreakyJoints and Dr. Curtis at the University of Alabama at Birmingham, is the first ever patient-led, patient-centered research registry for joint, bone, and inflammatory skin conditions. The free ArthritisPower mobile and desktop application allows patients to track and share their symptoms and treatments while simultaneously participating in research in a secure and easy manner. Patients can enter patient reported outcomes across many different measures including standard assessments such as the RAPID3. Collected over time, the data can then be shared with the patient’s rheumatologist in advance of appointments to encourage a data driven conversation. Both patient and physician will better understand how a patient is responding (or not) to treatment. ArthritisPower is supported by a multi-year, multi-million dollar investment of the Patient-Centered Outcomes Research Institute (PCORI) and is free to download from iOS or Android stores. There are already over 11,000 consented ArthritisPower participants who can track their disease and volunteer to participate in research studies. Data stemming from ArthritisPower PRO data is regularly presented at major medical conferences, including the most recent ACR meeting. To learn more and join ArthritisPower, visit http://www.ArthritisPower.org