How Critical is Tele‐Medicine to the Rheumatology Workforce?

Ward, I. M.; Schmidt, Thomas; Lappan, Charles M.; Battafarano, Daniel F.

doi:10.1002/acr.22853

Cited by 59 publications

(37 citation statements)

References 9 publications

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“…In contrast to other predictors of and barriers to telemedicine adoption [10–12], telemedicine familiarity is modifiable and should be a focus of future access efforts. Studies suggest that among those actually using the technology, acceptance is high [3, 4, 10], and hesitation is a characteristic of those not necessarily familiar with telemedicine [6]. The initial barrier seems to be convincing those who are unfamiliar that telemedicine is an acceptable and effective alternative.…”

Section: Discussionmentioning

confidence: 99%

“…Recognizing a clear deficit in the number and distribution of pediatric rheumatologists, a 2007 report to Congress recommended several remedies, including piloting telemedicine networks [2]. This was echoed in a more recent 2011 examination of the PR workforce [1], and telemedicine has also been viewed as a promising solution to access concerns in adult rheumatology [3]. Other solutions, such as shared-care, in which patients are co-managed with community-based physicians, have also been proposed [2].…”

Section: Introductionmentioning

confidence: 99%

“…Studies in other areas of medicine, including but not limited to adult rheumatology and other pediatric subspecialties, have reported high levels of satisfaction with telemedicine [3–5]; however, the acceptability is not universal. A recent survey which sampled households in rural Montana reported that a high percentage of respondents were unequivocally averse to using telemedicine for their healthcare, despite the inconvenience of in-person visits [6].…”

Section: Introductionmentioning

confidence: 99%

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Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents’ perceptions of barriers to care and care preferences

et al. 2017

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BackgroundThe United States pediatric rheumatology workforce is committed to a mission of providing children access to pediatric rheumatology care. With a limited number and distribution of pediatric rheumatologists, telemedicine has been proposed as one way to meet this mission, yet the adoption of this modality has been slower than expected. The purpose of this study was to explore the parent perspective on barriers to accessing pediatric rheumatology care and to explore the acceptability of telemedicine and other alternative care models.MethodsOver a period of six weeks, all new and return English-speaking parents/guardians of patients visiting a single center were offered an opportunity to complete a survey which assessed barriers to care and interest in alternative models of care. Responses were analyzed using descriptive statistics.ResultsSurvey response rate was 72% (159/221). Twenty-eight percent (45/159) traveled more than three hours to the pediatric rheumatology clinic, and 43% (65/152) reported travel as inconvenient. An overwhelming majority of respondents (95%, 144/152) reported a preference for in-person visits over the option of telemedicine. This preference was similar regardless of whether respondents reported travel to the clinic as inconvenient vs convenient (inconvenient 92%, 60/65; convenient 97%, 84/87; p = 0.2881) and despite those reporting travel as inconvenient also reporting greater difficulty with several barriers to care. Those familiar with telemedicine were more likely to report a preference for telemedicine over in-person visits (27%, 3/11 vs 3%, 4/140; p = 0.0087). The option of an outreach clinic was acceptable to a majority (63%, 97/154); however, adult rheumatology and shared-care options were less acceptable (22%, 35/156 and 34%, 53/156 respectively).ConclusionAmong survey respondents, in-person visits were preferred over the option of telemedicine, even when travel was noted to be inconvenient. Telemedicine familiarity increased its acceptability. Outreach clinics were acceptable to a majority. Ultimately, the parent perspective can shape acceptable ways to address barriers and provide accessible care.Electronic supplementary materialThe online version of this article (doi:10.1186/s12969-017-0184-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents’ perceptions of barriers to care and care preferences

et al. 2017

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“…Telerehabilitation can eliminate the need for travel, leading to considerable cost-and time-savings for patients (Levy, Silverman, Jia, Geiss, & Omura, 2015) and thus may potentially address the needs of those who are unwilling or unable to travel to physical therapy clinics in-person. This might include people who have limited time, live in a remote area, lack transportation, or have disabling conditions that make it difficult to attend clinics in-person (Kaambwa et al, 2017;Ward, Schmidt, Lappan, & Battafarano, 2016). For clinicians, the increased convenience and accessibility of telerehabilitation means that they can potentially reach a wider range of clientele who may otherwise be unable to attend clinics in-person (Lawford, Delany, Bennell, & Hinman, 2018a).…”

Section: Technology Provide S Opp Ortunitie S For Remotely-deliverementioning

confidence: 99%

Harnessing technology to deliver care by physical therapists for people with persistent joint pain: Telephone and video‐conferencing service models

Hinman

Lawford

Bennell

2018

J Appl Biobehavioral Res

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Purpose The burden of musculoskeletal conditions, particularly osteoarthritis (OA), is expected to increase in coming decades as the world's population ages, and obesity rates continue to rise. Self‐management via lifestyle interventions, such as exercise and physical activity, is integral to minimizing pain and maintaining physical function, yet access to qualified health professionals for evidence‐based advice and support is difficult for many people. This article discusses how technology provides new opportunities for delivering physiotherapy services remotely to people with persistent joint pain, through telephone, and internet‐mediated video conferencing. Methods The evidence for effectiveness of such service models is reviewed. Key challenges to implementation are discussed, and future directions for research in the field are highlighted. Results There is emerging evidence that the provision of care via telephone and internet‐mediated video technologies is effective for, and acceptable to, people with OA. Advantages include its convenience and accessibility, as well as the “hands‐off” nature of consultations. Challenges include patient safety and privacy and workforce willingness and capacity to deliver care via non‐traditional methods. Conclusions Using technology to deliver physiotherapy services to people with OA is feasible and acceptable to users; however, further research is required to expand the evidence‐base for remotely‐delivered physiotherapy service models.

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“…Due to the expected increase in rheumatoid arthritis (RA) , telehealth interventions have gained growing relevance as a mode for disease control . The treat‐to‐target strategy recommends that RA disease activity be measured at least every 4–6 months in patients with low disease activity or remission .…”

Section: Introductionmentioning

confidence: 99%

Experiences With Telehealth Followup in Patients With Rheumatoid Arthritis: A Qualitative Interview Study

Knudsen

Thurah

Lomborg

2018

Arthritis Care & Research

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The participants had positive perceptions of the PRO-based telehealth followup and saw it as a flexible and resource-saving solution. They reported disadvantages related to missing face-to-face contact with health professionals. The 2 typologies, the keen and the reluctant patient, help us understand the patients' different needs, wishes, and abilities to take part in telehealth followup. Our findings reveal a need for more insight into how telehealth followup could be integrated in routine clinical practice, paying special attention to how reluctant patients may be supported.

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How Critical is Tele‐Medicine to the Rheumatology Workforce?

Cited by 59 publications

References 9 publications

Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents’ perceptions of barriers to care and care preferences

Telemedicine and other care models in pediatric rheumatology: an exploratory study of parents’ perceptions of barriers to care and care preferences

Harnessing technology to deliver care by physical therapists for people with persistent joint pain: Telephone and video‐conferencing service models

Experiences With Telehealth Followup in Patients With Rheumatoid Arthritis: A Qualitative Interview Study

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