Evaluation of Rheumatoid Arthritis Outcome Measures between Users and Non-Users of the Patient Portal

Abstract

IntroductionPatient engagement has become a growing focus in healthcare, catalyzed with the passage of the HITECH Act in 2009.  Stage 2 of Meaningful Use has criteria dependent on a patient portal, however whether electronic patient engagement translates into better clinical outcomes is yet to be determined.  To begin an evaluation into this we reviewed outcomes in rheumatoid arthritis patients who had signed up for the patient portal compared to those who did not. MethodsData was obtained from a retrospective chart review of rheumatoid patients seen at the Ohio State University Rheumatology Clinics.  Outcome measures including the most recent sedimentation rate (ESR), Rapid 3, and swollen joint count were evaluated.  Two tailed t tests for these outcomes were done between each the group who had signed up for the patient portal and those that did not. Results132 patients were included with 66 having signed up for the patient portal (Users) and 66 not signed up for the patient portal (Non-users).  103 (78.0%) of patients were female, with a mean age of 55 ±13.79 years.  Outcome measures between the patients who signed up for the patient portal compared to those who had not 14.77 ±7.57 compared to 13.48 ±7.73 (p=0.33) for Rapid 3 scores, 1.97 ±2.25 compared to 2.86 ±4.06 (p=0.16) for swollen joint count, and 39.88 ±29.76 mm/hour compared to 30.61 ±22.04 mm/hour (p=0.04) for ESR. ConclusionsThis initial study cohort does not demonstrate any clinically significant difference in several key outcome measures in rheumatoid arthritis, particularly Rapid 3 scores and swollen joint counts.  However there was a statistical difference between the ESR, with more favorable values in patients using the patient portal.  This data suggests further study is needed to better understand if electronic patient engagement does have an effect on clinical outcomes in RA.