Also, the component of the physical exam is very important, especially in rheumatology. Measuring skin scores or even assessing for synovitis through telemedicine is a challenge.
Q: How do your patients like telemedicine appointments?
Patients appreciate having the option to do telemedicine visits. They have expressed that it means a lot to them that physicians are willing to try innovation to continue care while maintaining patient safety as a priority.
The patients have been very receptive. They are hoping this technology becomes a long-term part of our healthcare system. [Many] patients have told me that if a telemedicine visit [hadn’t been] offered, they would have likely missed their rheumatology appointment. They are really scared of the current situation with the pandemic. They are not comfortable leaving their house and much less comfortable coming to a healthcare setting.
I would like to emphasize that it’s crucial that patients consent beforehand. They should have the option to opt in or out [of a televisit]. I treasure the bond we share with our patients as we take care of them. I would not want to compromise on the human aspect of medicine. We have to keep our patients at the center as we develop and adopt new protocols. This would include making sure we stay HIPAA compliant, maintain patient preference, [adopt] user-friendly platforms and receive adequate training.
Hurdles regarding receiving proper reimbursement for telemedicine visits from federal, state and private insurers need to be overcome as well. For many insurance plans, telemedicine services can be obtained only through in-network providers. Although some of these restrictions have been loosened or waived during the pandemic, this may be a hurdle for sustaining telemedicine long term.
Q: What role do you see telemedicine playing in the future? Is it here to stay and, if so, how should it be used?
I believe it’s here to stay. The provision of healthcare services and education over a distance through the use of technology increases access and improves care for patients with rheumatic diseases. In the future, this [ability] could mean world experts could be accessed by patients all over the U.S. This [access] would be wonderful for patients, especially those with a rare disease, such as scleroderma, who are not able to travel far distances—whether for physical or monetary reasons—for a consultation.
This [ability] would in no way replace face-to-face visits, but it could be useful when conducted at appropriate intervals and for individual cases. For example, patients with chronic lung disease who are stable, but need to arrange transport to bring them to the clinic over long distances, may benefit from swapping an in-person visit for a televisit from time to time—as long as their disease is stable.
