Telehealth Brings Opportunities to Enhance Patient Care

During an ACR webinar in August, presenters discussed multiple aspects of telehealth in rheumatology, especially related to rheumatology fellowship training. They agreed that although telehealth represents one potential avenue to improve patient access to treatment for rheumatic disease, we must keep identifying the best ways to employ telehealth to enhance care.

Impact of Pandemic

Telemedicine broadly refers to the use of technology to deliver healthcare at a distance; telehealth includes an even broader scope of remote healthcare services, including non-clinical ones, such as provider training. Many telehealth options are now available, although insurance requirements and other constraints make some impractical; these include synchronous videoconferencing and audio-only visits, which many patients and care providers are now familiar with due to their expansion since the COVID-19 pandemic.^1,2

Asynchronous interactions between patients and providers are another telehealth option; for example, these have been effective in helping patients with gout achieve their target serum urate levels.³ Asynchronous, provider-to-provider interactions using shared electronic health records (i.e., e-consults) are another important telehealth option. Additionally, telementoring (i.e., using remote technologies to train primary care providers in rheumatology topics) is another important avenue.

Dr. Danila

The moderator of the webinar, Maria I. Danila, MD, MSc, MSPH, a professor of medicine at the University of Alabama at Birmingham, received an innovation award in 2021 from the Rheumatology Research Foundation to study how telehealth impacts access and quality of care in rheumatology. Three recipients of the Foundation’s Clinician Scholar Educator Award, designed to enhance education in autoimmune and musculoskeletal diseases, also participated in the panel: Jason R. Kolfenbach, MD, Lisa A. Zickuhr, MD, MHPE, and Marcy B. Bolster, MD. All three are pursuing projects connected to designing fellowship curricula related to telehealth.

“I think it’s fantastic how proactive the ACR and the Foundation have been in promoting the use of telehealth as a modality to enhance the care we provide our patients, in terms of the support for research in this area and support for the patient experience,” said Dr. Bolster, associate professor of medicine at Harvard Medical School and director of the rheumatology fellowship training program at Massachusetts General Hospital, Boston. “I think that rheumatologists are being very proactive in this area.”

Expanded Rheumatic Care

The panel participants agreed the COVID-19 pandemic dramatically accelerated telehealth in unprecedented ways as the rheumatology community adapted to the immediate crisis. “Telehealth practice would not have been what it is today without the healthcare community’s capacity to rapidly redesign processes to deliver medical care to the members of our community,” said Dr. Danila.