Enhancing Care Partnerships Using a Rheumatology Dashboard: Bringing Together What Matters Most to Both Patients and Clinicians

Abstract

Objective: Dashboards can support person-centered care by helping people partner with their clinicians to coproduce care based on preferences, shared decision-making, and evidence-based treatments. We engaged caregivers of children with juvenile idiopathic arthritis (JIA), adults with rheumatoid arthritis (RA), and clinicians in a pilot study to assess their experiences and the utility and impact of an electronic previsit questionnaire and point-of-care dashboard to support coproduction of rheumatology care.

Methods: We employed a mixed-methods design to assess users' perceptions of a customized electronic health record rheumatology module at four pediatric rheumatology practices and two adult rheumatology practices. We surveyed a convenience sample of caregivers of children with JIA (n = 113), adults with RA (n = 116), and clinicians (n = 12). We conducted semistructured interviews with 13 caregivers and patients and six care teams. Experiences were evaluated using descriptive statistics and thematic analyses.

Results: Caregivers of children with JIA and adults with RA reported the dashboards were useful during discussions (88%) and helped them talk about what mattered most (82%), make health care decisions (83%), and create a treatment plan (77%). Clinicians provided similar feedback. Two-thirds (67%) of caregivers and adults and 55% of clinicians would recommend the dashboard to peers. System usability scores (77.1 ± 15.6) were above average. Dashboards helped users make sense of health information, communicate more effectively, and make decisions. Improvements to the dashboards and workflows could enhance patient self-management and clinician efficiency.

Conclusion: Visual point-of-care dashboards can support caregivers, patients, and clinicians to coproduce rheumatology care. Findings demonstrate a need to spread and scale for broader benefit and impact.

Figure 1

Dashboard screenshots. A, Adult rheumatology dashboard. B, Pediatric rheumatology dashboard. Native rheumatology module components include a body diagram (homunculus), tender joint count, swollen joint count, and disease activity on the left‐hand panels. The dashboards longitudinally display these data, along with treatments or medications, on a timeline (right‐hand panels). Abbreviations: CDAI, Clinical Disease Activity Index; cJADAS, Clinical Juvenile Arthritis Disease Activity Score; CRP, C‐reactive protein; DAS28: Disease Activity Score‐28; ESR, erythrocyte sedimentation rate; JADAS‐10, Juvenile Arthritis Disease Activity Score; RAPID‐3, Routine Assessment of Patient Index Data.

Figure 2

Utility of dashboard. JIA, juvenile idiopathic arthritis; RA, rheumatoid arthritis