Background RA therapy needs regular disease activity assessment to sustain remission . Due to the fact that the activity fluctuates between visits, patient self-assessment at home can effectively support therapy process . Using mobile devices for self-monitoring is getting more and more popular, but in RA patients it could be limited by their age and manual disability. Design and development of mobile applications need to be based on healthcare data standards to achieve interoperability, being key success factor for widespread and effective use of applications and collected data.
Objectives The aim of the study was to design and develop mobile application for supporting disease activity monitoring by RA patients and to assess its usability and interoperability.
Methods Simple questionnaire, consisting of 4 screens: VAS General Health, Early Morning Stiffness Duration, VAS Pain and Drug Compliance, was designed and developed in the form of mobile application for smartphones. 15 patients with RA, average age 63.4±10.1, filled in the questionnaire twice and 12 of them evaluated usability of the application. Exact times needed to fill in each screen were recorded for analysis. The data from the application were being collected by HL7 FHIR  compliant server. The interoperability of the interface was tested at official HL7 FHIR connectathon.
Results Total time of the first use of the questionnaire was 91.1±23.1 s and it dropped to 48.6±19.8 s at the second use by the same patient. All patients agreed that application is generally easy-to-use and intuitive. 10 of 12 patients had no difficulties to fill in the questionnaire on mobile device and all 12 concluded that mobile VAS is at least as easy to complete as in paper form. Patients did not experience any application errors and the only suggestion for improvement was request to change the font size and was raised by the 2 oldest patients (72 and 78 years of age). The mobile application and HL7 FHIR server successfully passed interoperability tests at the HL7 FHIR Connectathon 8 in January 2015 .
– Manual disability in RA patients is not an obstacle for using mobile applications.
– RA patients perceive mobile VAS as equally easy-to-use as traditional paper VAS.
– Healthcare data standards based interoperability of mobile applications can be easily achieved with no negative influence on their usability.
Wolfe F, Rasker JJ, Boers M, Wells GA, Michaud K Minimal disease activity, remission, and the long-term outcomes of rheumatoid arthritis Arthritis Rheum. 2007 Aug 15;57(6):935-42.
Curtis JR1, Shan Y, Harrold L, Zhang J, Greenberg JD, Reed GW Patient perspectives on achieving treat-to-target goals: a critical examination of patient-reported outcomes. Arthritis Care Res (Hoboken). 2013 Oct;65(10):1707-12.
HL7 FHIR Wiki. http://wiki.hl7.org/index.php?title=FHIR (Accessed 24 Jan 2015)
HL7 FHIR Connectathon, 2015 January San Antonio. https://docs.google.com/spreadsheets/d/1o_86Hn2FnAqFjiKqbSRjhKwbPSjt3ONKnvAykWqXEHo/edit?pli=1#gid=1 (Accessed 24 Jan 2015)
Acknowledgements This work was partially supported by the European Union in the FICHe program. The mobile application tests were performed in cooperation with the Association of People with Rheumatism and their Friends.
Disclosure of Interest None declared