Improving ILD Screening in Patients With RA and SSc Using EHR-Embedded CDS and PRO Tools

This is a quality improvement initiative that aims to find better ways to identify interstitial lung disease (ILD) early in people with rheumatoid arthritis (RA) or systemic sclerosis (SSc). ILD is a serious lung problem that can develop in these conditions but is often missed. The project will test whether tools built into the electronic health record (EHR), including symptom surveys that patients complete on a tablet and alerts that help doctors decide when lung testing is needed, can increase screening rates. About 16 rheumatology clinics that use the same EHR system will take part. All clinics will eventually use the new tools, but they will start at different times. This allows researchers to compare usual care to the new approach within each clinic. Adults with RA or SSc who have not previously been diagnosed with ILD and who have not had recent lung testing will be included automatically through their routine clinic visits. The study expects to include about 800 patients in total. The main question is whether more eligible patients receive recommended ILD screening, which includes either a pulmonary function test or a high-resolution CT scan, within seven days of their clinic visit. The study will also look at how often lung tests are ordered and completed, how often patients report symptoms such as shortness of breath or cough, and whether the alerts lead to real-time clinical decisions. This project lasts two years and uses information already collected during routine clinical care. No additional procedures or medications are required.

Participants must meet all of the following to be included: Age ≥ 18 years Diagnosis of rheumatoid arthritis (RA) or systemic sclerosis (SSc) No prior diagnosis of interstitial lung disease (ILD) No high-resolution CT (HRCT) or pulmonary function test (PFT) within the past 24 months Participants meeting any of the following are excluded: Confirmed diagnosis of ILD Recent HRCT or PFT within the last 24 months without new symptoms