Telemedicine As a Feasible Alternative for Treatment of RA
New studies continue to support the practice of telemedicine as an effective approach to disease management for people who live in rural areas. People who live in those areas often find themselves prevented from seeking appropriate care because of the restrictions of geographic access. Veterans, in particular, have been solving for this by using telemedicine (TM) to receive treatment and monitoring of numerous medical conditions including rheumatoid arthritis (RA).
Telemedicine reduces disparities in care
Clinical studies and patient survey results report telemedicine users have a high level of satisfaction with the experience. Convenience, reduced travel time and lower associated costs are just some of the reasons cited. Researchers have found improved clinical results, patient satisfaction, and more efficient use of the health care system.
Rural veterans often lack access to medical care because of geographic barriers. Telemedicine’s remote access to appropriate providers equalizes access to care, regardless of location.2
How does telemedicine work?
Telemedicine is a virtual house call. Technology connects doctors and patients, allowing them to communicate using two-way video via smartphones, tablets, or computers. It permits people to reach doctors they might not otherwise be able to see in a comfortable and convenient way.
Telemedicine has been used to provide rural primary medicine as well as to bring specialists to people who live too far away from care centers or are unable to travel. This is especially important to veterans who receive care from VA facilities which are spread out around the country but may not be accessible to those who live in remote locations.
How is this applicable to RA?
Obstacles to care access such as geography, physical or financial ability to travel, and wait time prevent some people from seeking appropriate care. For people with RA, treatment using telemedicine has improved access with no discernable change in treatment outcomes.2
Measuring patient satisfaction
A Routine Assessment of Patient Index Data 3 (RAPID-3) evaluation instrument has been used in studies to evaluate distance traveled, out-of-pocket costs, and patient satisfaction. Sample data were compiled on patients with inflammatory arthritis who received traditional in-office care as well, also known as usual care.
No difference in doctor-patient time for telemedicine and usual care
Telemedicine visits were compared with the results obtained with usual care. Results revealed that telemedicine experiences were not particularly different from in-person visits when assessing the length of time and interview portions of office visits. Telemedicine visits also included a modified physical exam. The doctor may ask a patient to show affected body parts to the camera, go through a series of movements to demonstrate agility or areas of pain or discomfort.
Advances in technology will continue to improve access to care. For veterans and others with RA, there needs to be an ongoing evaluation of benefits as well as limitations associated with virtual medicine and the remote delivery of care.
What does the future hold with telemedicine?
In one study, veterans with inflammatory arthritis who had sought arthritis treatment at the research study local tertiary medical center as well as primary care at affiliated secondary or tertiary care sites were identified and enrolled in a prospective year-long pilot telemedicine program. The sample size consisted of 85 people, 25 participants received telemedicine care, and 60 got traditional care. The evaluation tools used for the assessment were considered significant predictors of visit satisfaction.
Telemedicine for remote patients
The findings published in the Journal of Clinical Rheumatology suggest that telemedicine visits combined with medical assessment technologies can be effectively used for rheumatology care of remote patients. It holds long term promise for reducing disparities of care for those who are less mobile or face geographic barriers. Factors that influence patient satisfaction include distance to care, time spent, and associated financial expenses
As telemedicine and associated technologies continue to evolve, it appears that this modality can offer beneficial care options that merit being part of future medical care delivery solutions.
- Jacobs, S. Using Telemedicine in Rheumatology: Outcomes, Costs, and Patient Satisfaction. Available at: https://www.rheumatologyadvisor.com/home/topics/practice-management/using-telemedicine-in-rheumatology-outcomes-costs-and-patient-satisfaction/. Accessed 7.9.19.
- Wood PR, Caplan, L. Outcomes, Satisfaction, and Costs of a Rheumatology Telemedicine Program: A Longitudinal Evaluation. Available at: https://www.ncbi.nlm.nih.gov/pubmed/30461466. Accessed 7.9.19.