Experience with telemedicine amongst rheumatology clinicians during the COVID-19 pandemic: an international survey

Abstract

Objective To assess rheumatology clinicians’ perceptions of telemedicine as well as their experiences before and during the COVID-19 pandemic. Methods We conducted a cross-sectional online survey and collected responses from rheumatology clinicians worldwide between November 2020 and February 2021, regarding use and perceptions of telemedicine in rheumatology. We summarized data with descriptive statistics and qualitative analysis for free-text responses. Results The survey was completed by 349 rheumatology clinicians from 49 countries; 59% were female and one-third were 30–50 years old. Academic affiliations were held by 55% of participants and 44% were from North America. Prior to the pandemic, 24% of participants had experience with telemedicine, while about three-quarters used telemedicine for the first time during the pandemic. Overall, 56% thought they provided less adequate care with telemedicine. More than half of clinicians felt that telemedicine was adequate for evaluating crystalline arthritis, inflammatory arthritis, and lupus flares. Telemedicine was felt to be inadequate for flares of myositis, vasculitis, and scleroderma. Technical problems were reported in 29% of telemedicine encounters and were most commonly related to patient-encountered difficulties. Conclusion . Most rheumatology clinicians used telemedicine for the first time during the pandemic. The quality of care provided was thought to be inferior to that provided in-person for specific clinical situations. Additional efforts are needed to address barriers to effective telemedicine such as patient-related technology issues, challenges with building rapport, and performing a physical examination and to define the appropriate scope of clinical scenarios conducive to telemedicine.

Blood self-sampling: a missing link for remote patient care

“…Despite some digital patient management platforms have been in place already before 2020, they were telephone consultations, and emerging video consultations have kept patient care at a low level. 3 …”

“…The COVID-19 lockdown was a sudden and unexpected stress test for remote patient care in practices and hospitals. Despite some digital patient management platforms have been in place already before 2020, they were telephone consultations, and emerging video consultations have kept patient care at a low level 3…”

Follow-Up of Patients With Axial Spondyloarthritis in Specialist Health Care With Remote Monitoring and Self-Monitoring Compared With Regular Face-to-Face Follow-Up Visits (the ReMonit Study): Protocol for a Randomized, Controlled Open-Label Noninferiority Trial

“…Furthermore, patients have reported that self-monitoring of the disease enables them to see the connection between behavioral factors (eg, taking medications and lifestyle choices) and disease concerns [ 1 ]. However, a survey regarding the use of digital technology during the COVID-19 pandemic revealed that HPs considered remote care inferior to face-to-face visits [ 21 ]. In a recent study, both patients and HPs considered remote care inferior to face-to-face visits, but remote care was convenient for patients in relation to reduced traveling and waiting times [ 22 ].…”

Willingness, perceived facilitators and barriers to use remote care among healthcare professionals – a cross-sectional study

“…Remote care is in an early phase, and research on facilitators and barriers is required in order to integrate and adopt remote care into standard practice [ 11 – 14 ]. Earlier studies on facilitators and barriers to remote care in rheumatology have primarily focused on experiences from rheumatologists during the COVID-19 pandemic [ 10 , 15 , 16 ]. Since these, previous studies were conducted during the COVID-19 pandemic when physical consultations were limited to a minimum, there may be a bias towards more positive attitudes concerning remote care.…”