Project 461029

The current way of delivering care for people living with inflammatory rheumatic diseases (IRD) does not meet patients' needs, is outdated by 2022 standards, does not efficiently use the very effective therapies that are now available, and amplifies health inequities. Our research will use digital health and innovative strategies to change how care is delivered to overcome these issues. We propose to co-design, with stakeholders, a new way of delivering care that is flexible and tailored to patients' needs, the Flexible Care Delivery model. We expect the frequency of follow-ups, modalities of visits (virtual or in person), and health care professional seen, would be flexible, based on symptoms and how the disease impacts a person's physical, emotional and social health. This information, along with clinical information from electronic medical records, patient factors that may influence need for care, and patient preference, would inform when patients are seen and what care they receive. Specifically, during this planning grant, we will: 1. Engage various stakeholders, including patients, arthritis health professionals, and healthcare decision makers in the co-design of the Flexible Care Delivery model. 2. Identify what features are essential for the model to be acceptable to all, and feasible to implement, and obtain agreement on the specific elements of the model. 3. Identify the unique needs of specific groups at higher risk of health inequities (such as elderly, immigrants, housing insecure) that need to be taken into consideration when designing and implementing the model, by partnering with community organizations. 4. Identify the digital health technology and infrastructure necessary to deliver the new model. We anticipate our new approach will be more patient-centered, will lead to better health, with less inequities, will save lives and reduce costs. Although designed and tested for IRD, our flexible approach could be repurposed for other chronic diseases.