Our team of researchers will work with patients, families, healthcare professionals and health care decision-makers, to design a new system of delivering care (a ‘model’). Decisions about the care to be received will be decided with patients based on remote monitoring of their health between visits.

Information such as symptoms and laboratory tests will be gathered into a web-based remote monitoring system, which will trigger ‘alerts’ to the clinical team when results indicate a possible need for care (e.g., if lab tests are abnormal or if symptoms have become more severe ). These alerts will guide individualized care by determining when an appointment is set, how care will be received (virtual vs. in-person), and by whom, i.e. which health care professional will be seen (e.g. doctor vs. nurse).

This study will involve multiple steps:

1. Engaging with key partner groups, including persons living with arthritis and auto-immune rheumatic diseases; organizations that serve communities at greater risk of health inequities; health care professionals providing arthritis care; clinic administrative staff; health care decision-makers and policymakers; and technical experts.
2. Conducting group discussions (focus groups) and one-on-one interviews with patients, healthcare professionals, health care decision-makers and study partners to inform the co-design of the new model and identify essential features needed for the model to be feasible and acceptable to all.
3. Conducting discrete-choice experiments, where patients and clinicians are surveyed to identify what matters most to people and evaluate trade-offs people are willing to make when adopting this way of delivering care. .
4. Developing and testing the web-based alert system that will be created to monitor patient’s health remotely and guide care.
5. Testing the feasibility of implementing FlexCAre in clinical practice