The research study included three phases.

Phase One was conducted in collaboration with the Arthritis Alliance of Canada (AAC) and the Canadian Rheumatology Association (CRA). A series of focus groups and interviews were held with people living with arthritis, physicians, allied health providers, healthcare managers and policymakers. The purpose of phase one was to understand what is necessary for providing high-quality care for people with rheumatoid arthritis in Canada.

In Phase Two, the aim was to create a scorecard for measuring the quality of care for rheumatoid arthritis that aligned with findings from Phase One. First, a systematic review was conducted to identify existing quality measures in rheumatoid arthritis care and map them according to the findings in Phase One. Second, a group of experts in the field of performance measurement and two patient partners were brought together to finalize the measures to be included in the scorecard. These measures were used to inform Phase Three.

Phase Three was conducted in collaboration with the Alberta Medical Association’s Physician Learning Program. First, five quality measures that focus on treating rheumatoid arthritis according to ‘treat-to-target’ principles were selected from the 21 measures identified in phase two. The five measures included regular follow-ups, documenting disease activity, timely appointments for non-remission patients, achieving low disease activity, and remission rates. Then, the measures were tested and put into action in real-life rheumatology clinics and were reported on by physicians via ‘practice reports’. This research also captured how rheumatologists felt about receiving personalized reports on their performance. Data was collected using Rheum4U, an online platform for quality improvement and research.