Grant: Project Grant

Rheumatoid arthritis (RA) is a costly chronic autoimmune disease of the joints that affects nearly half a million Canadians, with direct Canadian healthcare costs estimated at over $2 billion. Early and targeted RA therapy can prevent damage and disease complications. Given the incredible economic burden of this disease to the Canadian public, it is counterintuitive that the quality of RA care is not routinely monitored, as variations in adherence to evidence-based practices may result in poorer patient outcomes. One approach to mitigate this gap in practice is to institute a balanced scorecard to monitor and improve RA quality of care at a system, provider and individual level. The balanced scorecard is a structured approach to improving efficiency and performance and is increasingly applied in healthcare. A key element of this approach is reporting performance measures, capturing multiple dimensions of quality of care, and using this information to inform healthcare improvements. There still remains a knowledge gap on the use of scorecards in healthcare, as existing scorecards frequently lack input from patients and report measures that are largely of interest for healthcare managers and planners. Furthermore, scorecards are infrequently used in chronic diseases, such as RA, as they are most commonly applied to monitor inpatient and acute care settings. In this project, we will develop a patient-centered balanced scorecard for RA to facilitate quality monitoring. We will collaborate with Canadian arthritis stakeholders including healthcare providers and patients living with arthritis and leverage arthritis networks including the Arthritis Alliance of Canada to develop the scorecard. We will then pilot the scorecard using a recently developed electronic platform (Rheum4U) and an electronic medical record system. This tool will improve arthritis quality of care monitoring and reporting and has great potential to be applied to other disease conditions.