“The average engagement time per page was less than a minute—about 54 seconds,” Dr. Reid said. “That told us we need to keep information very succinct and to the point so it can be used in real-time efficiently in the clinics.”
Dr. Reid highlighted the website’s feedback survey, which is accessible on every page, as a key tool for ongoing improvement. “We are still in the first iteration of the site and greatly appreciate the feedback we’ve received from providers and patient groups,” she said.
Dr. Reid noted that future priorities include stronger partnerships with foundations, expanding patient-informed content and collaborating with other organizations to better reach primary care providers.
Screening Strategies for In-Person Visits
Next, Alexis Ogdie, MD, MSCE, professor of medicine and epidemiology at the University of Pennsylvania, Philadelphia, presented on strategies for determining when patients need our care.
“As you practice for many years, the reality is we cannot see all the patients who need to be seen every four to six months,” Dr. Ogdie said. “The goal is to figure out how to identify patients who need to be seen urgently and which patients do not need to see you as often.”
In a pilot study, Dr. Ogdie enrolled patients in a program in which they were sent a RAPID-3 ahead of their clinic visit. For high RAPID-3 scores, patients would be evaluated as usual with in-person visit to determine if inflammatory arthritis or an alternative etiology, such as fibromyalgia, was the cause.5
“Patients in remission or low disease activity, by RAPID-3, with no significant change in the overall RAPID-3 score, had the option to change their visit to telemedicine or see an advanced practice provider instead,” Dr. Ogdie said.
Other ways to triage include holding spots reserved for patients flaring in templates, asking patients to reschedule follow-up appointments for six months later if doing well and using patient-reported outcome (PRO) measures in advance of appointments to shift timing.
“The RAPID3 can be helpful as a PRO for inflammatory arthritis,” Dr. Ogdie said. Other specific PROs for axial spondyloarthritis and psoriatic arthritis, respectively, include Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Psoriatic Arthritis Impact of Disease (PsAID).
Wearables
Finally, wearable technologies are devices that enable continuous, objective disease monitoring beyond the clinic.6 Wearables include activity and mobility trackers (e.g., Fitbit or Garmin), joint-specific devices, such as smart gloves for rheumatoid arthritis, which are still under development, cardiovascular monitors (e.g., WHOOP Strap or Apple watch), and sleep/recovery monitors (e.g., the Oura Ring).
