![o Rheumatoid arthritis (RA) is a long term condition
o Characterised by changes in disease severity over time
o Symptoms can be fleeting – at times an ‘invisible disease’
o Consultations occur relatively infrequently
o Dependent on patient’s recall, eloquence and stoicism
o Tools exist for capturing information on disease activity
[PROMs], but these are not completed on a routine basis
Rationale for the study](https://image.slidesharecdn.com/t3blynnaustin-160708160403/85/Remote-Monitoring-of-Rheumatoid-Arthritis-using-a-Smartphone-app-2-320.jpg)
Remote Monitoring of Rheumatoid Arthritis using a Smartphone app
- 1. REMORA Funded by: Arthritis Research UK CLAHRC Greater Manchester REmote MOnitoring of Rheumatoid Arthritis using a Smartphone app Dr LynnAustin, Research Fellow, University of Manchester ~ on behalf of the REMORA team ~
- 2. o Rheumatoid arthritis (RA) is a long term condition o Characterised by changes in disease severity over time o Symptoms can be fleeting – at times an ‘invisible disease’ o Consultations occur relatively infrequently o Dependent on patient’s recall, eloquence and stoicism o Tools exist for capturing information on disease activity [PROMs], but these are not completed on a routine basis Rationale for the study
- 3. Rheumatology clinic - current context “How have you been in the last six months?” “Oh… alright, I suppose.”
- 4. Aims of the study To develop and evaluate a Smartphone app for people with Rheumatoid Arthritis to facilitate routine recording of their symptoms between clinic visits Medical records Clinicians at hospital Researchers at university Research database Collect data once and use for multiple purposes: Patients at home Smartphone app
- 5. Stage 1 Stage 2 Stage 3 o Reaching agreement on the components of the app o Developing the systems required to link the data entered to the Electronic Patient Record oTesting the app for 1 month with 8 patients o Checking system for ‘end to end’ processes o ‘Bug fixing’ & refining the app in response to feedback o Evaluating the refined app for 3 months with 24 patients o Summarising feedback from a range of stakeholders o Producing an implementation toolkit for the app developed Overview of the study
- 6. The REMORA team and study activities Flow of data from point of entry to EPR Appearance of app Format of question sets Presentation in EPR Preferences in relation to phone app Economic implications • What to record • How to record • When to record Interviews: Patients (21) Clinicians (10) Researchers (12)
- 7. Patients Clinicians Researchers Stage 1: Identifying the components of the app
- 8. Patients Guiding consultation Self-management Clinicians Researchers Stage 1: Identifying the components of the app
- 9. Clinicians Guiding consultations Triage outpatients Patients Guiding consultation Self-management Researchers Stage 1: Identifying the components of the app
- 10. Researchers Source of temporally-rich data e.g. Measurement of flares,/treatment response Patients Guiding consultation Self-management Clinicians Guiding consultations Triage outpatients Stage 1: Identifying the components of the app
- 11. The REMORA app
- 12. The REMORA app
- 13. Anonymiseddata Linked to EPR via NHS N3 secure networkSafe haven Stage 2: Checking ‘end to end’ processes Data entered submitted via public internet
- 14. Stage 2: ‘Post app’ consultations
- 15. A graph of acknowledgment A great idea A doddle More personal to you With a graph…you can see what’s going on You’ve got solid proof straightaway It reassured me It’s a shared conversation Stage 2: Early feedback on using the app
- 16. Stage 2: Post-testing refinements to the app Refinements suggested: • Inclusion of a ‘back key’ • Clearer indication of when data had been entered/next due • More prominent reminder message • Additional question regarding things that may have had an impact on their RA over the previous week (e.g. exercise medication)
- 17. “Let’s see how you’ve been over the last 6 months” Rheumatology clinic - the future
- 18. For further details please contact a member of the research team: Lynn Austin - Research Fellow lynn.austin@manchester.ac.uk Will Dixon - Chief Investigator will.dixon@manchester.ac.uk Caroline Sanders – Co investigator caroline.sanders@manchester.ac.uk Funded by: Arthritis Research UK CLAHRC Greater Manchester