title: Touchscreen questionnaire patient data collection in rheumatology practice: development of a highly successful system using process redesign.
abstract: OBJECTIVE
  While questionnaires have been developed to capture patient-reported outcomes (PROs) in rheumatology practice, these instruments are not widely used. We developed a touchscreen interface designed to provide reliable and efficient data collection. Using the touchscreen to obtain PROs, we compared 2 different workflow models implemented separately in 2 rheumatology clinics.
  
  
  METHODS
  The Plan-Do-Study-Act methodology was used in 2 cycles of workflow redesign. Cycle 1 relied on off-the-shelf questionnaire builder software, and cycle 2 relied on a custom programmed software solution.
  
  
  RESULTS
  During cycle 1, clinic 1 (private practice model, resource replete, simple flow) demonstrated a high completion rate at the start, averaging between 74% and 92% for the first 12 weeks. Clinic 2 (academic model, resource deficient, complex flow) did not achieve a consistent completion rate above 60%. The revised cycle 2 implementation protocol incorporated a 15-minute "nurse visit," an instant messaging system, and a streamlined authentication process, all of which contributed to substantial improvement in touchscreen questionnaire completion rates of ∼80% that were sustained without the need for any additional clinic staff support.
  
  
  CONCLUSIONS
  Process redesign techniques and touchscreen technology were used to develop a highly successful, efficient, and effective process for the routine collection of PROs in a busy, complex, and resource-depleted academic practice and in typical private practice. The successful implementation required both a touchscreen questionnaire, human behavioral redesign, and other technical solutions.
authors.affiliation: Geisinger Health System, Danville, Pennsylvania, USA. enewman@geisinger.edu
authors.forename: Eric D
authors.initials: ED
authors.lastname: Newman
authors.forename: Virginia
authors.initials: V
authors.lastname: Lerch
authors.forename: J B
authors.initials: JB
authors.lastname: Jones
authors.forename: Walter
authors.initials: W
authors.lastname: Stewart
mesh_terms: D003195:Computer Communication Networks; D003198:Computer Simulation; D001330:Electronic Data Processing / Q000639:trends*; D006801:Humans; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D019095:Point-of-Care Systems / Q000639:trends*; D016730:Program Development; D012216:Rheumatic Diseases / Q000628:therapy*; D057566:Self Report; D012984:Software; D011795:Surveys and Questionnaires