Final set of system level performance measures for IA (complete measure specifications shown in the Supplementary Data, available online at jrheum.org).
| Measures | Descriptions | Reporting |
|---|---|---|
| Performance Measure 1: Waiting times for rheumatologist consultation for patients with new onset IA | The number of days that patients waited, between the date the initial referral was received and the date of consultation with a rheumatologist for patients with new onset IA where the diagnosis of IA is made or confirmed by a rheumatologist. | Primary measure reported: The 50th and 90th percentile waiting times for rheumatologic consultation for each subtype of IA (RA, PsA, AS, JIA)*. Additional data to be reported: percentage of patients with IA who had a waiting time equal to or shorter than the benchmark waiting times recommended for their specific IA diagnosis based on the WTA (reported for each subtype of IA). |
| Performance Measure 2: Percentage of patients with IA seen by a rheumatologist | The percentage of patients with new onset IA with at least 1 visit to a rheumatologist in the first year of diagnosis, regardless of who makes the diagnosis. | The percentage of patients with new onset IA (incident IA) with at least 1 visit to a rheumatologist in the first year of diagnosis. We propose reporting on this measure for each subtype of IA (RA, PsA, AS, JIA)**. |
| Performance Measure 3: Percentage of patients with IA seen in yearly followup by a rheumatology team member | The percentage of patients with a diagnosis of IA under the care of a rheumatology team seen in followup by a rheumatology team member at least once per year. | The percentage of patients with IA seen by their rheumatology team member at least once every year over the measurement period***. |
| Performance Measure 4: Percentage of patients with RA treated with a DMARD | The percentage of patients with RA with a DMARD medication prescribed or dispensed during the measurement year. | Primary measure reported: Percentage of patients with RA with a DMARD medication prescribed or dispensed during the measurement year. |
| Performance Measure 5: Time to DMARD therapy in RA | The number of days between the diagnosis of RA and the time that a DMARD medication was prescribed or dispensed, where the diagnosis of RA was made or confirmed by a rheumatologist. | Primary measure reported: 50th and 90th percentile times between RA diagnosis and DMARD prescription or dispensing where the diagnosis of RA was made or confirmed by a rheumatologist. Additional data to be reported: percentage of patients with RA who had a waiting time equal to or shorter than the benchmark waiting times set by the WTA for initiating DMARD treatment. |
| Performance Measure 6: Rheumatologists per capita | How many rheumatologists per 100,000 population. | Primary measures reported: (1) The number of adult rheumatologists per 100,000 population. (2) The number of FTE adult rheumatologists per 100,000 population. (3) The number of pediatric rheumatologists per 100,000 pediatric population. (4) The number of FTE pediatric rheumatologists per 100,000 pediatric population. Additional data to be reported: (1) Adult rheumatology training programs: Y/N. (2) Pediatric rheumatology training programs: Y/N |
↵* It is not recommended to report an overall wait time for IA given the heterogeneity of disease and targets for wait times.
↵** It is not recommended to report overall percentages for IA as a combined measure given the heterogeneity of these diseases. Also note that this is not a waiting time measure. This measure will provide an estimate of how many patients with RA are not being seen by a rheumatologist.
↵*** For all types of IA, shorter followup intervals may be highly appropriate and recommended based on disease activity/severity. This measure represents a minimum and will indicate whether patients are getting lost to a minimum level of followup. IA: inflammatory arthritis; RA: rheumatoid arthritis; AS: ankylosing spondylitis; PsA: psoriatic arthritis; JIA: juvenile idiopathic arthritis; WTA: Wait Time Alliance; DMARD: disease-modifying antirheumatic drug; FTE: full-time equivalents; Y/N: Yes/No.