eHealth in Rheumatology

The aim of the ELECTOR project is to develop, implement, and evaluate an eHealth platform for home-based monitoring of patients with arthritis. The adaptive and flexible nature of this solution will change the provision of health care and may be disseminated to monitor a variety of diseases.

EU member states are facing an immense challenge due to an increased number of elderly citizens and prevalence of chronic diseases, a relatively lower number of employed citizens and an increasing expectation of high quality services from today’s health care consumers. These changes induce an increased prevalence of patients with chronic illnesses and prompt a general shortage of health care resources and staffing.

Rheumatic diseases have a large economic and social impact in the European societies, and a recent publication demonstrates that musculoskeletal diseases are the second largest reason for lost disability adjusted life years. Rheumatoid arthritis is the most common chronic inflammatory joint disease, and about 3.500.000 individuals are affected in the EU. Rheumatoid arthritis is a chronic, systemic disease and the inflammatory process leads to joint damage and loss of function. A growing body of evidence has emphasized the consistent clinical and radiographic benefits of continuous inflammatory control as a cornerstone in any treatment setup.

The increasing therapeutic options and demanding treatment goals of contemporary management of patients with chronic rheumatologic diseases calls for further development of the traditional monitoring methods, which involves time consuming and resource demanding visits in the hospital clinic. In arthritis, the current clinical care set-up includes an assessment of the patients’ joints, blood samples, and the recording of patient reported outcomes. They are all completed at the hospital departments and for most rheumatology departments these data are captured via paper forms.

Due to the above-mentioned challenges this extensive monitoring is increasingly troubling the health care system and data implies that a large proportion of health care resources are used to complete these planned visits. One consequence of this is that the health care system is challenged in its ability to completely adhere to international recommendations advocating tight monitoring and adjustment of all patients until remission or low disease activity is reached and sustained. In practice, this means that patients may be scheduled for a visit past the recurrence of disease activity and that this added time with increased disease activity might induce an unnecessary length of symptoms and perhaps even an increased prevalence of joint damage.

It is likely that many patients could and would prefer to do the monitoring themselves and that patients participating in home-based care would experience a higher degree of self-control and influence and ultimately increase patients’ empowerment and well being.

The proposed eHealth platform will encompass point-of-care devices used for measuring biochemistry at home and a web-based graphical user interface for communication, knowledge transfer and for the reporting of questionnaires as well as joint assessments.

The end result is a platform that will provide an integrated and direct collection of data into patient notes in the set-up of an eHealth outpatient clinic for citizens with rheumatoid arthritis. This solution will constitute a reliable, safe and straightforward method for obtaining self-assessments and facilitate easy and rapid access to health care assistance at times of need for the individual patient.