# Improved clinical care and capacity through an integrated electronic patient-reported outcome measure and health record system in inflammatory arthritis

## TL;DR

An electronic system for tracking arthritis patient outcomes improved care efficiency and patient engagement.

## Contribution

A fully integrated ePROM system was implemented and evaluated for real-world clinical impact in inflammatory arthritis.

## Key findings

- ePROM completion rates increased from 25% to 66% compared to paper methods.
- The system saved 1500 clinic hours annually by reducing follow-up appointments.
- The new-to-follow up ratio improved from 1:3.1 to 1:2.2 over five years.

## Abstract

Patient-reported outcome measures (PROMs) are essential for inflammatory arthritis (IA). Collecting electronic PROMs (ePROMs) remotely into electronic patient records (EPRs) enables timely, patient-centred care. This study evaluated the real-world clinical impact, efficiency and feasibility of implementing a fully integrated ePROM system across three IA conditions: rheumatoid arthritis, axial spondyloarthritis and psoriatic arthritis.

From January 2019 to December 2024, IA patients completed ePROMs remotely at regular intervals or on request by patients or clinicians, with data automatically uploaded to the EPR. Alerts based on predefined thresholds prompted clinical review. Patients with stable disease were transitioned to patient-initiated follow-up. Outcomes include ePROM completion rates, patient engagement, satisfaction, appointment utilisation, time savings and the new-to-follow up (N:FU) ratio. Time saved was estimated by calculating reduced follow-up appointments multiplied by 20-min consultation length. We assessed effectiveness through patient and clinician engagement and satisfaction.

The ePROM completion rates improved from 25% (paper) to 66% (ePROM). A total of 1500 clinic hours per year were saved through reduced follow-ups. The N:FU ratio improved from 1:3.1 in 2019 to 1:2.2 in 2024. Increased capacity enabled shorter waiting times for new and urgent follow-up patient clinic appointments. Longitudinal ePROM trends provided better actionable insight than single time points.

The integrated ePROM system enhanced PROM completion, enabled safe remote monitoring and supported expansion of patient-initiated follow-up. The system improved the efficiency and responsiveness of IA care as well as promoted personalised care.