AB1566-HPR DIGITAL TOOL FOR MONITORING INFLAMMATORY RHEUMATIC DISEASES IN CLINICAL PRACTICE
Authors: D. V. Mendoza Mendoza, M. Cuaresma Giráldez, A. Moreno Conde, I. M. Fernández-Maeztu Palacín, C. Dominguez, J. J. Pérez Venegas
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Clinical assessment in rheumatology has undergone a major change in recent decades. The importance of quantifying disease burden and measuring health outcomes has led to develope and validate different indexes for each rheumatic disease. The indexes' calculation requires a specific calculator. The time that it takes and the inability to perform the calculations directly from the patient's clinical report is a limitation to their routine use in clinical practice <h3>Objectives:</h3> To create a digital tool that calculates the indexes in such a way that they can be integrated into the a patient's medical record and facilitate monitoring of the evolution of single patients and patient populations. <h3>Methods:</h3> A multidisciplinary team of engineers, rheumatologists and rheumatology nurses was set up in order to define the parameters to be quantified and decide on the indexes to be calculated. The most useful and feasible validated indexes for Rheumatoid arthritis (RA), Psoriatic arthritis (PsA) and axial spondyloarthritis (AxSp) in clinical practice were selected (DAS28 and CDAI for RA, DAPSA for PsA and ASDAS for AxSp). The variables for the indexes' calculation as well as their mathematical formulas were communicated to the engineering team. A tool for direct access from the patient's digital medical record was developed, in which the parameters for calculating the indexes are collected. The index calculated is recorded in numerical form on a platform and added to the patient's medical record. It also automatically records the categorised disease activity (remission, low activity, moderate activity or high activity) according to the index value. This tool also allows the recording of consecutive patient visits.Work is underway to integrate patient report outcomes and quality of life questionnaires into the platform in the next phase. This database will also be connected to the hospital pharmacy databases in the future. <h3>Results:</h3> The tool was developed jointly by the Rheumatology Department and the <i>Innovation Unit</i> at <i>Hospital Universitario Virgen Macarena.</i> Over two months, the way in which the data was integrated, the clinical details, the units for collecting laboratory data and the proper performance of the calculations were improved. The results of the calculations made with this tool were compared to those obtained with a pre-existing mobile phone application (App) designed for this purpose (ReumaHelper©). The tool was improved and validated in routine clinical practice for 8 months. This tool has proven to be able to calculate the indexes as well as the App, with the added value of being directly integrated into the patient's digital medical record, avoiding transcription errors and unnecessary time consumption (Figure 1). The exploitability of the data collected has also been evaluated. It is possible to evaluate the evolution of an index in a patient over a period of time as well as the clinical disease activity of a group of patients (Figure 2), with the ability to analyse the evolution of any of the parameters collected for the indexes' calculation (TJC, SJC, CRP...). All information collected is saved and can be exported directly into data analysis programs. <h3>Conclusion:</h3> The recording of indexes is a standard of quality care and is increasingly integrated into clinical practice being essential for objective decision-making. The digitalisation of this process allows us a more efficiently indexes calculation. The integration of de activity indexes into the patient's medical record is a great step forward in increasing its implementation in clinical practice. Beyond the calculation of the index at a specific moment, the use of this tool allows us to: 1)evaluate the clinical evolution of a patient 2)carry out analyses of health results in different patient groups 3)select patient populations for research studies, with data directly incorporated in a usable database <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>