However, Dr. Bolster said, “I also think that as a specialty we are still learning about the right times for a virtual visit. Because there are times that it is truly beneficial for a patient to come in.” She noted that from pre-pandemic data we know some patients are not as well suited for in-person visits, so it is important to consider aspects such as the disease type, level of disease activity, the systemic nature of the disease and the clarity of diagnosis.10,11 Additionally, some patients face important barriers to virtual care, such as limited access to technology. Providers must consider these potential barriers when considering telehealth options for specific patients.
“We learned from being thrust into virtual care that we can use it to enhance the care we are already providing our patients,” said Dr. Bolster. “We don’t need to replace our care like we did in March 2020; now we can use it as another facet of how we take care of our patients.”
“I think that we’ve laid the foundation of telemedicine,” added Dr. Zickuhr. “Now we get to fine tune it and make it something that is really effective for both patients and providers.”
Ruth Jessen Hickman, MD, is a graduate of the Indiana University School of Medicine. She is a freelance medical and science writer living in Bloomington, Ind.
References
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- Miloslavsky EM, Bolster MB. Addressing the rheumatology workforce shortage: A multifaceted approach. Semin Arthritis Rheum. 2020 Aug;50(4):791–796.
- Yokose C, Jorge A, D’Silva K, et al. Using electronic visits (e-visits) to achieve goal serum urate levels in patients with gout in a rheumatology practice: A pilot study. Semin Arthritis Rheum. 2020 Dec;50(6):1382–1386.
- Battafarano DF, Ditmyer M, Bolster MB, et al. 2015 American College of Rheumatology Workforce Study: Supply and demand projections of adult rheumatology workforce (2015–2030). Arthritis Care Res (Hoboken). 2018 Apr;70(4):617–626.
- Agley J, Delong J, Janota A, et al.. Reflections on project ECHO: qualitative findings from five different ECHO programs. Med Educ Online. 2021 Dec;26(1):1936435.
- Bae JM. Shared decision making: relevant concepts and facilitating strategies. Epidemiol Health. 2017 Oct 30;39:e2017048.
- Deniz S, Akbolat M, Çimen M, Ünal Ö. The mediating role of shared decision-making in the effect of the patient-physician relationship on compliance with treatment. J Patient Exp. 2021 May 20;8:23743735211018066.
- Borondy Kitts A, Chandra S, Evans N, et al. Association of American Medical Colleges. Telehealth Competencies across the Learning Continuum. AAMC New and Emerging Areas in Medicine Series. Washington, DC: AAMC; 2021. https://www.aamc.org/data-reports/report/telehealth-competencies
- Zickuhr L, Albert DA, Herndon C, et al. Addressing competency in rheumatology telehealth care delivery. Arthritis Care Res (Hoboken). 2022 Sep;10.1002/acr.25023.
- Ferucci ED, Holck P, Day GM, Choromanski TL, Freeman SL. Factors associated with use of telemedicine for follow-up of rheumatoid arthritis. Arthritis Care Res (Hoboken). 2020 Oct;72(10):1404-1409.
- Kulcsar Z, Albert D, Ercolano E, Mecchella JN. Telerheumatology: A technology appropriate for virtually all. Semin Arthritis Rheum. 2016 Dec;46(3):380-385.
