New Key Performance Indicators Assist in Diagnosis and Treatment of RA, Osteoarthritis

Integral to timely and effective diagnosis and treatment, key performance indicators have been developed to evaluate central intake systems for osteoarthritis and rheumatoid arthritis.

Arthritis stakeholders have developed 28 key performance indicators (KPIs) to improve quality and efficacy of centralized intake systems for osteoarthritis (OA) and rheumatoid arthritis (RA) treatment and diagnosis, according to research published in Arthritis Research and Therapy.

“The reasons for delays in care for appropriate treatment of patients with OA and RA are complex,” wrote lead author Claire E. Barber, MD, FRCPC, of the University of Calgary Department of Medicine in Calgary, Canada. “Centralized intake…facilitates getting the right patients to the right providers at the right time.”

KPIs for centralized intake of arthritis care were developed over the course of a 3-phase process. In phase 1, arthritis stakeholders–including healthcare providers, researchers, patients, and patient engagement researchers–established and defined measurement priorities, resulting in 25 potential KPIs. Phase 2 included an integrative literature review of evidence, best practices, and existing performance measures to ensure that each KPI could be supported. In phase 3, stakeholders participated in a 3-round, online, modified Delphi procedure. In the first round of phase 3, panelists anonymously rated KPIs; in the second round, panelists reviewed the results and were able to anonymously participate in an asynchronous online discussion. During this time, a number of KPIs were removed and some were modified to better reflect measurement priorities. Finally, in the third round, panelists voted on the modified KPIs. Ultimately, each KPI was evaluated on scientific validity, face validity, feasibility, importance, and likelihood of use.

During phase 2, 13 KPIs were harmonized with existing measures. Phase 3 included 7 OA-specific KPIs, 10 RA-specific KPIs, and 8 KPIs applied to centralized intake systems for both conditions. In phase 3, round 2, three of the original KPIs were removed from the final round of voting. Additionally, panelists recommended a number of new KPIs that they felt “more effectively captured measurement priorities.” A total of 28 KPIs were submitted for voting in the third round: 9 OA-specific KPIs, 10 RA-specific KPIs, and 9 KPIs applied to centralized intake systems for both conditions.

“OA and RA were chosen because these are the 2 most common arthritis conditions in the general population and represent prototypical inflammatory and noninflammatory arthritis,” wrote Dr Barber and colleagues. “There is strong evidence that better access to care and treatment in these conditions leads to improved patient outcomes.”

Researchers conclude that all KPIs should be tested further using existing data sources including administrative data and clinical databases before widespread implementation. 


Barber CE, Patel JN, Woodhouse L, et al. Development of key performance indicators to evaluate centralized intake for patients with osteoarthritis and rheumatoid arthritis. Arthritis Res Ther. 2015; 17:322. doi: 10.1186/s13075-015-0843-7.