THU0641 USE OF A WEB-BASED RHEUMATOLOGY PATIENT MANAGEMENT PORTAL
Authors: Tin Aung, Robert Sharpe, Roope Manhas, Stuart Kyle
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> The benefit of incorporating tele-rheumatology into standard care is increasingly recognised. In January 2017, we introduced a web-based Rheumatology Patient Management Portal (RPMP), developed by MedMet, to our rheumatology patients at the North Devon District Hospital. In 2018 the portal service was fully operational. Suitable patients included undifferentiated inflammatory arthritis, rheumatoid arthritis, psoriatic arthritis and spondyloarthritides. Patients were consented to collected data such as diagnosis, treatment and disease activity onto the RPMP. For a selected group of patients who agreed to their email use, we set up schedules in the form of email reminders for them to complete PROMs (patient reported outcome measures) such as Health Assessment Questionnaire, Spinal Pain, Bath Ankylosing Spondylitis Disease Activity Index and Work Productivity and Activity Impairment. Patients can also report disease flares electronically, which is acknowledged by a health care professional who will contact them with advice as necessary. <h3>Objectives</h3> To understand patient participation in the use of the RPMP, between 01.01.18 and 31.12.18. To develop a cohort of clinically stable patients who can self-manage via RPMP use and scheduled PROMs. The potential to remotely manage these patients has the advantage of reducing the number of face-to-face clinic appointments and eventually will lead to setting up a virtual clinic. To examine patient perception on the RPMP use. To examine whether tele-rheumatology is a useful adjunct to standard care. <h3>Methods</h3> The data was collected from interrogating the web-based RPMP database. Specific data was reviewed including; total number of patients on the portal, number of patients consenting to use their email, number of PROMs completed on the RPMP, number of flares reported and time to acknowledgment. In order to gain further understanding of user experience, a survey questionnaire (figure 1) was sent on 14.01.19. <h3>Results</h3> In total we have 883 patients recruited to the RPMP. During the study period of one year, 289 patients have consented to share their emails and set up schedules. Therefore 33% of patients on the RPMP are using their emails through 2018. 310 patients responded to their portal request to complete a schedule. 758 PROMs were completed as part of the schedule response. 1744 PROMs were completed face to face whilst in standard clinic review. Therefore, 30% of PROMs were completed through a scheduled response. 55 patients contacted us through the RPMP to report a flare. The average time to acknowledging a flare is 37 hours. 78% of flare reports were acknowledged within 3 days. Results from the survey of patient experience as follow: number of patients responded to the survey was 99 and respond rate was 34%. Among them, 94% reported the RPMP as easy to use, 54% found that RPMP helped them in understanding their rheumatology condition and 25% reported a flare through the RPMP. <h3>Conclusion</h3> A large number of our rheumatology patients have consented to use the RPMP and their email. Uptake of the RPMP use is increasing (figure 2). We have identified a significant proportion of 289 patients using the portal and email that could be targeted for virtual clinic use. Our data showed that use of tele-rheumatology in conjunction with standard care has potential to reduce number of standard clinic appointments however further work is required to investigate this. Feedback from clinical staff is that having PROMs completed prior to consultation gives more time to discuss key issues whilst facilitating appropriate monitoring. The survey showed that majority of patients found the RPMP easy to use and helpful in understanding their rheumatology condition. The RPMP is an effective monitoring system for selected patients and has improved patient understanding in monitoring their disease activity. <h3>Disclosure of Interests</h3> Tin Aung: None declared, Robert Sharpe: None declared, Roope Manhas: None declared, stuart kyle Consultant for: but no conflict of interest.