title: Improving the quality of care of patients with rheumatic disease using patient-centric electronic redesign software.
abstract: OBJECTIVE
  Electronic health records (EHRs) are not optimized for chronic disease management. To improve the quality of care for patients with rheumatic disease, we developed electronic data capture, aggregation, display, and documentation software.
  
  
  METHODS
  The software integrated and reassembled information from the patient (via a touchscreen questionnaire), nurse, physician, and EHR into a series of actionable views. Core functions included trends over time, rheumatology-related demographics, and documentation for patient and provider. Quality measures collected included patient-reported outcomes, disease activity, and function. The software was tested and implemented in 3 rheumatology departments, and integrated into routine care delivery. Post-implementation evaluation measured adoption, efficiency, productivity, and patient perception.
  
  
  RESULTS
  Over 2 years, 6,725 patients completed 19,786 touchscreen questionnaires. The software was adopted for use by 86% of patients and rheumatologists. Chart review and documentation time trended downward, and productivity increased by 26%. Patient satisfaction, activation, and adherence remained unchanged, although pre-implementation values were high. A strong correlation was seen between use of the software and disease control (weighted Pearson's correlation coefficient 0.5927, P = 0.0095), and a relative increase in patients with low disease activity of 3% per quarter was noted.
  
  
  CONCLUSIONS
  We describe innovative software that aggregates, stores, and displays information vital to improving the quality of care for patients with chronic rheumatic disease. The software was well-adopted by patients and providers. Post-implementation, significant improvements in quality of care, efficiency of care, and productivity were demonstrated.
authors.affiliation: Geisinger Medical Center, Danville, Pennsylvania.
authors.forename: Eric D
authors.initials: ED
authors.lastname: Newman
authors.forename: Virginia
authors.initials: V
authors.lastname: Lerch
authors.forename: Jon
authors.initials: J
authors.lastname: Billet
authors.forename: Andrea
authors.initials: A
authors.lastname: Berger
authors.forename: H Lester
authors.initials: HL
authors.lastname: Kirchner
mesh_terms: D057286:Electronic Health Records / Q000592:standards / Q000639:trends*; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care / Q000592:standards / Q000639:trends*; D011787:Quality of Health Care / Q000592:standards / Q000639:trends*; D012216:Rheumatic Diseases / Q000175:diagnosis* / Q000628:therapy*; D012984:Software / Q000592:standards / Q000639:trends*; D011795:Surveys and Questionnaires