Background: Project Sonar (PS) is a community-based registry and disease management program developed by the Illinois Gastroenterology Group (IGG) to improve clinical and economic outcomes in patients with Inflammatory Bowel Disease (IBD). PS integrates monthly patient-reported health-related quality of life (HRQoL) information using a subset of questions from the Crohn's Disease Activity Index (CDAI) sent via a Patient Portal (PP) producing a monthly "Sonar Score." These scores are then joined by clinical data fields delivered through electronic medical record derived Clinical Decision Support tools (CDS). This combined data is analyzed against payer provided-claims data to provide comprehensive performance information to physicians and practice administrators on practice patterns. In an effort to improve portal-based patient response rates PS deployed the SonarMD Platform (SMDP), a mobile application platform developed by SonarMD, LLC which uses smartphone technology to improve patient engagement instead of an internet browser-based PP.
Methods: Patient surveys were developed using 5 questions derived from the Crohn's Disease Activity Index in an effort to obtain HRQoL scores. The sum of the values on these questions results in a Sonar Score (SS) which produces a quantifiable assessment of HRQoL. SSs are monitored for individual scores as well as the slope of change over time, which allows for the development of care management algorithms that drive therapeutic interventions. The PP was used to send these surveys from January 2014 through May 2015. Due to an unacceptable PP response rate, the SMDP was developed. It was deployed in June 2015. Patient response rates were compared for 3 month periods using each of the 2 methods.
Results: The total number of surveys sent during the final 3 months of the PP was 514. Of these there were 142 responses and 372 nonresponses resulting in a patient response rate for the PP averaged 27.6%. The total number of surveys sent in the first 3 months using the SMDP was 507. Of these there were 336 responses and 171 nonresponses resulting in a patient response rate for the SMDP of 66.27%. Since the SMDP platform automatically calculates the SS at the time the patient answers the survey, patients receive immediate algorithm derived responses and staff time spent communicating results with enrollees was significantly reduced as a result.
Conclusions: Project Sonar provides a unique opportunity to combine electronic medical records, healthcare claims/resource utilization data, and patient reported outcomes to predict treatment failure and target appropriate therapy in a community-based setting. Since patient participation is critical to the success of PS, the cloud-based SMDP's superior performance improved the patient response rate over the patient portal from 27.6% to 66.27%. It also resulted in significant savings in staff time and the opportunity for providing immediate algorithm-derived patient responses.
(C) Crohn's & Colitis Foundation of America, Inc.