Background Research supporting the use of digital platforms to increase efficiency in clinical settings has emerged and yet implementation remains a challenge. This can be explained by the unique needs of clinics for data collection and electronic medical record integration.

Objective To identify how screening and monitoring of Rheumatoid Arthritis patients through a customized electronic platform, cliexa-RA impacts patient experience, physician experience, cost of care, and population health based on the Institute for Healthcare Improvement’s quadruple aim.

Methods cliexa-RA was delivered on three tablets at the Colorado Arthritis Center over a six-month period to patients and physicians, who were asked to complete a 16-question intake form allowing patients to score their ability to complete daily tasks using the RAPID3 scoring system, and a six-question patient engagement survey. The physician would then input 28 joint assessment scores following a physical examination. cliexa-RA would then calculate five disease state scores, DAS28 (ESR), DAS28 (CRP), SDAI, CDAI, RAPID3, and send an EMR-compatible PDF file.

Results Time stamp and patient satisfaction data was collected on 300 patients. Patient intake forms and self-reporting took an average of 2.4 minutes, and clinic-reported time required for calculation and transcription of the data using cliexa-RA was 1 minute with an additional 10 second direct data integration to the EMR after form submission. Eighty-five percent of patients said they would recommend cliexa forms to other clinicians. cliexa-RA scored an average of 3.57 out of 4 when compared to paper in ease of use, 3.61 in patient-reported reduction of time spent, and 3.50 when asked how easy the platform was to understand. Overall patient satisfaction was scored at 3.55 out of 4 and physician experience was measured by the adoption of the program in the study clinic with full integration into the Greenway Health EMR (currently integration is pending). Cost of care and population health impacts were not immediately available as a result of the pilot study; however, numerous savings and improvement opportunities exist as a result of cliexa-RA implementation.

Conclusion Patient experience and physician engagement had immediate positive impacts from the implementation of cliexa-RA. Cost of care opportunities exist in both time savings and annual Medicare reporting costs. Population health opportunities exist in the collection of patient data, increasing informed decision making by physicians, as well as in the potential for future RA research using this data.

The authors have declared no competing interest.

This study did not receive any funding

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

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The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The study utilized de-identified, non-interventional data collected as part of routine clinical operations and workflow optimization. No protected health information (PHI) was collected or analyzed by the cliexa platform, as patient identifiers were excluded and replaced with internal identifiers for EMR linkage purposes. Based on these factors, the work is considered not human subjects research and therefore exempt from IRB review.

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