Capturing Critical Data Elements in Juvenile Idiopathic Arthritis: Variations between In-person and Virtual Visits and Initiatives to Improve Data Capture

Abstract Background: Documentation of critical data elements is a focus of the Pediatric Rheumatology Care and Outcomes Improvement Network to aid in clinical care and research for patients with juvenile idiopathic arthritis. We aimed to increase data capture for arthritis pain score, patient/parent global assessment of wellbeing, provider global assessment, and active joint count. We hypothesized that data capture for all critical data elements would be lower for virtual visits compared to in-person visits. Methods: All visits for patients with JIA between 9/14/2020 and 12/31/2021 at the University of Minnesota were included. Sixteen interventions with providers were conducted, including email reminders, individual discussions, group meetings, and feedback reports. We used statistical process control charts to evaluate change over time.Results: Baseline included 355 patient-visits: 221 (62%) in-person and 134 (38%) virtual with critical data elements entry ranging between 50-60%. Post-intervention included 1,596 patient-visits: 1,350 (85%) in-person and 246 (15%) virtual with critical data elements entry of 91%. In-person visits had significantly higher data capture rates than virtual visits for all 4 critical data elements.Conclusion: We achieved our aim to increase critical data element documentation and found that collection of critical data elements occurred significantly less often with virtual visits than with in-person visits. We inferred that critical data element capture for virtual visits was lower for multiple reasons, including the lack of intake forms and provider uncertainty about scoring certain elements. Now that we improved capture of critical data elements, we can shift the focus to efforts aimed at improving outcomes for patients with juvenile arthritis.