{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:36:51Z","timestamp":1791999411973,"version":"4.4.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":240,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/rap\/rkaf101","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T11:41:53Z","timestamp":1756294913000},"source":"Crossref","is-referenced-by-count":5,"title":["Improved clinical care and capacity through an integrated electronic patient-reported outcome measure and health record system in inflammatory arthritis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2323-8161","authenticated-orcid":false,"given":"Antoni","family":"Chan","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Royal Berkshire NHS Foundation Trust , Reading,","place":["UK"]},{"name":"Digitalisation, Marketing and Entrepreneurship Department, Henley Business School, University of Reading , Reading,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn","family":"Rigler","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Royal Berkshire NHS Foundation Trust , Reading,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nneoma","family":"Zabbey","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Royal Berkshire NHS Foundation Trust , Reading,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liz","family":"van Rossen","sequence":"additional","affiliation":[{"name":"Physiotherapy Department, East Kent Hospitals University NHS Foundation Trust , Canterbury,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mustansar","family":"Hussain","sequence":"additional","affiliation":[{"name":"Information Management and Technology Department, Royal Berkshire NHS Foundation Trust , Reading,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hubbard","sequence":"additional","affiliation":[{"name":"Information Management and Technology Department, Royal Berkshire NHS Foundation Trust , Reading,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"2025110501304050500_rkaf101-B1","doi-asserted-by":"crossref","first-page":"e001707","DOI":"10.1136\/rmdopen-2021-001707","article-title":"Use and detailed metric properties of patient-reported outcome measures for rheumatoid arthritis: a systematic review covering two decades","volume":"7","author":"Ay\u015fe","year":"2021","journal-title":"RMD Open"},{"key":"2025110501304050500_rkaf101-B2","doi-asserted-by":"crossref","DOI":"10.1136\/rmdopen-2024-004687","article-title":"Combining patient-reported outcome measures to screen for active disease in rheumatoid arthritis and psoriatic arthritis","volume":"10","author":"Looijen","year":"2024","journal-title":"RMD Open"},{"key":"2025110501304050500_rkaf101-B3","doi-asserted-by":"crossref","first-page":"472","DOI":"10.3899\/jrheum.2023-0894","article-title":"Axial spondyloarthritis treatment recommendations and disease activity monitoring in clinical practice: results of an online survey","volume":"51","author":"Sinnappan","year":"2024","journal-title":"J Rheumatol"},{"key":"2025110501304050500_rkaf101-B4","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1186\/s12969-021-00551-z","article-title":"Electronic forms for patient reported outcome measures (PROMs) are an effective, time-efficient, and cost-minimizing alternative to paper forms","volume":"19","author":"Yu","year":"2021","journal-title":"Pediatr Rheumatol Online J"},{"key":"2025110501304050500_rkaf101-B5","doi-asserted-by":"crossref","first-page":"e15588","DOI":"10.2196\/15588","article-title":"Benefits and disadvantages of electronic patient-reported outcome measures: systematic review","volume":"3","author":"Meirte","year":"2020","journal-title":"JMIR Perioper Med"},{"key":"2025110501304050500_rkaf101-B6","doi-asserted-by":"crossref","first-page":"e0253615","DOI":"10.1371\/journal.pone.0253615","article-title":"Electronic patient-reported outcome measures using mobile health technology in rheumatology: a scoping review","volume":"16","author":"Shelton","year":"2021","journal-title":"PLoS One"},{"key":"2025110501304050500_rkaf101-B7","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1016\/j.clon.2021.06.004","article-title":"The routine clinical implementation of electronic patient-reported outcome measures (ePROMs) at The Christie NHS Foundation Trust","volume":"33","author":"Crockett","year":"2021","journal-title":"Clin Oncol (R Coll Radiol)"},{"key":"2025110501304050500_rkaf101-B8","doi-asserted-by":"crossref","first-page":"rkac065","DOI":"10.1093\/rap\/rkac065","article-title":"Successful integration of an automated patient-reported outcome measure within a hospital electronic patient record","volume":"6","author":"Neame","year":"2022","journal-title":"Rheumatol Adv Pract"},{"key":"2025110501304050500_rkaf101-B9","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1002\/art.42559","article-title":"The clinical impact of electronic patient-reported outcome measures in the remote monitoring of inflammatory arthritis: a systematic review and meta-analysis","volume":"75","author":"Arumalla","year":"2023","journal-title":"Arthritis Rheumatol"},{"key":"2025110501304050500_rkaf101-B10","doi-asserted-by":"crossref","first-page":"676","DOI":"10.1016\/j.jss.2015.09.015","article-title":"Standards for QUality Improvement Reporting Excellence 2.0: revised publication guidelines from a detailed consensus process","volume":"200","author":"Ogrinc","year":"2016","journal-title":"J Surg Res"},{"key":"2025110501304050500_rkaf101-B11","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1186\/s12916-018-1050-6","article-title":"Analysing the role of complexity in explaining the fortunes of technology programmes: empirical application of the NASSS framework","volume":"16","author":"Greenhalgh","year":"2018","journal-title":"BMC Med"},{"key":"2025110501304050500_rkaf101-B12","first-page":"193","article-title":"The NASSS framework\u2014a synthesis of multiple theories of technology implementation","volume":"263","author":"Greenhalgh","year":"2019","journal-title":"Stud Health Technol Inform"},{"key":"2025110501304050500_rkaf101-B13","doi-asserted-by":"crossref","first-page":"i6","DOI":"10.1093\/rap\/rkad015","article-title":"How to self-examine for tender and swollen joints: co-producing a training video for people with rheumatoid arthritis","volume":"7","author":"Sharp","year":"2023","journal-title":"Rheumatol Adv Pract"},{"key":"2025110501304050500_rkaf101-B14","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.1002\/acr.23799","article-title":"International consortium for health outcome measurement set of outcomes that matter to people living with inflammatory arthritis: consensus from an international working group","volume":"71","author":"Oude Voshaar","year":"2019","journal-title":"Arthritis Care Res (Hoboken)"},{"key":"2025110501304050500_rkaf101-B15","doi-asserted-by":"crossref","first-page":"e002898","DOI":"10.1136\/rmdopen-2022-002898","article-title":"Points to consider for cost-effective use of biological and targeted synthetic DMARDs in inflammatory rheumatic diseases: results from an umbrella review and international Delphi study","volume":"9","author":"van der Togt","year":"2023","journal-title":"RMD Open"},{"key":"2025110501304050500_rkaf101-B16","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1007\/s40744-021-00289-w","article-title":"A novel qualitative study assessing patient-reported outcome measures among people living with psoriatic arthritis or ankylosing spondylitis","volume":"8","author":"Chakravarty","year":"2021","journal-title":"Rheumatol Ther"},{"key":"2025110501304050500_rkaf101-B17","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1186\/s13075-021-02500-3","article-title":"Mobile App-based documentation of patient-reported outcomes - 3-months results from a proof-of-concept study on modern rheumatology patient management","volume":"23","author":"Richter","year":"2021","journal-title":"Arthritis Res Ther"},{"key":"2025110501304050500_rkaf101-B18","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1093\/jamia\/ocaa177","article-title":"Remote symptom monitoring integrated into electronic health records: a systematic review","volume":"27","author":"Gandrup","year":"2020","journal-title":"J Am Med Inform Assoc"},{"key":"2025110501304050500_rkaf101-B19","doi-asserted-by":"crossref","first-page":"651","DOI":"10.1007\/s00296-023-05278-6","article-title":"Predictors for response to electronic patient-reported outcomes in routine care in patients with rheumatoid arthritis: a retrospective cohort study","volume":"43","author":"Wiegel","year":"2023","journal-title":"Rheumatol Int"},{"key":"2025110501304050500_rkaf101-B20","doi-asserted-by":"crossref","first-page":"2721","DOI":"10.1093\/rheumatology\/keae112","article-title":"Remote monitoring of patients with rheumatoid arthritis in a low disease activity state: a mixed methods evaluation across six hospitals in London, UK","volume":"63","author":"Watson","year":"2024","journal-title":"Rheumatology (Oxford)"},{"key":"2025110501304050500_rkaf101-B21","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1007\/s11136-024-03644-w","article-title":"Patient adherence and response time in electronic patient-reported outcomes: insights from three longitudinal clinical trials","volume":"33","author":"Nowojewski","year":"2024","journal-title":"Qual Life Res"},{"key":"2025110501304050500_rkaf101-B22","doi-asserted-by":"crossref","first-page":"e56196","DOI":"10.2196\/56196","article-title":"Implementing systematic patient-reported measures for chronic conditions through the Naveta value-based telemedicine initiative: observational retrospective multicenter study","volume":"12","author":"Mercadal-Orfila","year":"2024","journal-title":"JMIR Mhealth Uhealth"},{"key":"2025110501304050500_rkaf101-B23","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1007\/s11136-019-02304-8","article-title":"Strategies to improve patient-reported outcome completion rates in longitudinal studies","volume":"29","author":"Nielsen","year":"2020","journal-title":"Qual Life Res"},{"key":"2025110501304050500_rkaf101-B24","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1111\/1756-185X.13436","article-title":"An evaluation of the Virtual Monitoring Clinic, a novel nurse-led service for monitoring patients with stable rheumatoid arthritis","volume":"22","author":"Chew","year":"2019","journal-title":"Int J Rheum Dis"},{"key":"2025110501304050500_rkaf101-B25","first-page":"587","article-title":"Investigating the influence of patient eligibility characteristics on the number of deferrable rheumatologist visits: planning for a patient-initiated follow-up strategy","volume":"51","author":"Subdar","year":"2024","journal-title":"J Rheumatol"},{"key":"2025110501304050500_rkaf101-B26","article-title":"NHS long term plan","author":"NHS England","year":"2023"},{"key":"2025110501304050500_rkaf101-B27","doi-asserted-by":"crossref","first-page":"e848","DOI":"10.1016\/S2665-9913(24)00229-7","article-title":"Patient-initiated follow-up supported by asynchronous telemedicine versus usual care in spondyloarthritis (TeleSpA-study): a randomised controlled trial of clinical and cost-effectiveness","volume":"6","author":"Hermans","year":"2024","journal-title":"Lancet Rheumatol"},{"key":"2025110501304050500_rkaf101-B28","doi-asserted-by":"crossref","first-page":"2089","DOI":"10.1007\/s00296-024-05673-7","article-title":"Patients with axial spondyloarthritis reported willingness to use remote care and showed high adherence to electronic patient-reported outcome measures: an 18-month observational study","volume":"44","author":"Thomassen","year":"2024","journal-title":"Rheumatol Int"},{"key":"2025110501304050500_rkaf101-B29","article-title":"Rheumatology: GIRFT Programme National Specialty Report","author":"Kay","year":"2021"},{"key":"2025110501304050500_rkaf101-B30","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1038\/s41584-023-01008-1","article-title":"Remote monitoring in rheumatology: seeing the right patient at the right time","volume":"19","author":"Chan","year":"2023","journal-title":"Nat Rev Rheumatol"},{"key":"2025110501304050500_rkaf101-B31","doi-asserted-by":"crossref","first-page":"e18117","DOI":"10.2196\/18117","article-title":"Acceptance, usage, and barriers of electronic patient-reported outcomes among German rheumatologists: survey study","volume":"8","author":"Krusche","year":"2020","journal-title":"JMIR Mhealth Uhealth"},{"key":"2025110501304050500_rkaf101-B32","doi-asserted-by":"crossref","first-page":"e002516","DOI":"10.1136\/bmjoq-2023-002516","article-title":"Why it is hard to use PROMs and PREMs in routine health and care","volume":"12","author":"Benson","year":"2023","journal-title":"BMJ Open Qual"},{"key":"2025110501304050500_rkaf101-B33","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1002\/art.42774","article-title":"A mobile health application integrated in the electronic health record for rheumatoid arthritis patient-reported outcomes: a controlled interrupted time-series analysis of impact on visit efficiency","volume":"76","author":"Solomon","year":"2024","journal-title":"Arthritis Rheumatol"},{"key":"2025110501304050500_rkaf101-B34","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1093\/jamia\/ocv085","article-title":"Overcoming barriers to implementing patient-reported outcomes in an electronic health record: a case report","volume":"23","author":"Harle","year":"2016","journal-title":"J Am Med Inform Assoc"},{"key":"2025110501304050500_rkaf101-B35","doi-asserted-by":"crossref","first-page":"1178","DOI":"10.3899\/jrheum.2021-1410","article-title":"Online patient-reported outcome measure engagement is dependent on demographics and locality: findings from an observational cohort","volume":"50","author":"Yates","year":"2023","journal-title":"J Rheumatol"},{"key":"2025110501304050500_rkaf101-B36","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1007\/s11136-021-02999-8","article-title":"Patient-level barriers and facilitators to completion of patient-reported outcomes measures","volume":"31","author":"Long","year":"2022","journal-title":"Qual Life Res"}],"container-title":["Rheumatology Advances in Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/rheumap\/advance-article-pdf\/doi\/10.1093\/rap\/rkaf101\/64163101\/rkaf101.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/9\/4\/rkaf101\/64163101\/rkaf101.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/rheumap\/article-pdf\/9\/4\/rkaf101\/64163101\/rkaf101.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T06:30:50Z","timestamp":1762324250000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/rheumap\/article\/doi\/10.1093\/rap\/rkaf101\/8244297"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025]]},"references-count":36,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,8,1]]}},"URL":"https:\/\/doi.org\/10.1093\/rap\/rkaf101","relation":{},"ISSN":["2514-1775"],"issn-type":[{"value":"2514-1775","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025]]},"published":{"date-parts":[[2025]]},"article-number":"rkaf101"}}