The Impact of the COVID-19 Pandemic and Telemedicine Implementation on Practice Patterns and Electronic Health Record Utilization in an Academic Rheumatology Practice

Maheswaranathan, Mithu; Chu, Philip; Johannemann, Andrew; Criscione-Schreiber, Lisa G; Clowse, Megan E.B.; Leverenz, David

doi:10.1097/rhu.0000000000001751

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…For instance, 1 Italian study reported a smooth switch of 80% of the outpatient appointments to TM ( 28 ). Another study done in the US noted that TM peaked at 92% of the total visits and was accompanied by a large shift in provider EHR utilization ( 29 ). A research letter reported that 52.7% of patients with predominantly arthritis in a rheumatology department in Spain considered phone consultation to be useful, and no specific patient profile was associated with this opinion ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

Factors Associated With Use of Telemedicine for Follow-Up of SLE in the COVID-19 Outbreak

Chow

Cheng

et al. 2021

Front. Med.

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Objective: To investigate the factors associated with telemedicine (TM) use for follow-up of Systemic Lupus Erythematous (SLE) patients in the COVID-19 pandemic.Methods: This was a single-centered cross-sectional study conducted in Hong Kong. Consecutive patients followed up at the lupus nephritis clinic were contacted for their preference in changing the coming consultation to TM in the form of videoconferencing. The demographic, socioeconomic, and disease data of the first 140 patients opted for TM and 140 control patients preferred to continue standard in-person follow-up were compared.Results: The mean age of all the participants was 45.6 ± 11.8 years, and the disease duration was 15.0 ± 9.2 years. The majority of them were on prednisolone (90.0%) and immunosuppressants (67.1%). The mean SLEDAI-2k was 3.4 ± 2.4, physician global assessment (PGA) was 0.46 ± 0.62 and Systemic Lupus International Collaborating Clinics (SLICC) damage index was 0.97 ± 1.23. A significant proportion of the patients (72.1%) had 1 or more comorbidities. It was found that patients with higher mean PGA (TM: 0.54 ± 0.63 vs. control: 0.38 ± 0.59, p = 0.025) and family monthly income > USD 3,800 (TM: 36.4% vs. control: 23.6%; p = 0.028) preferred TM, while full-time employees (TM: 40.0% vs. control: 50.7%; p = 0.041) preferred in-person follow-up. These predictors remained significant in the multivariate analysis after adjusting for age and gender. No other clinical factors were found to be associated with the preference of TM follow-up.Conclusion: When choosing the mode of care delivery between TM and physical clinic visit for patients with SLE, the physician-assessed disease activity and patient's socio-economic status appeared to be important.

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Section: Discussionmentioning

confidence: 99%

Factors Associated With Use of Telemedicine for Follow-Up of SLE in the COVID-19 Outbreak

Chow

Cheng

et al. 2021

Front. Med.

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“…Some of these effects were expected—such as reducing barriers to care from workforce shortages and improving access to healthcare for rural or underserved patients (Battafarano et al., 2018; Lennep et al., 2020). However, some of the impacts of telemedicine on rheumatology practices were unexpected; a prior study at our institution demonstrated that the rapid transition to telemedicine during the COVID‐19 pandemic significantly affected rheumatologists' prescription patterns of disease‐modifying antirheumatic drugs, indicating that the adoption of telemedicine had clinical implications for certain care practices in rheumatology (Maheswaranathan et al., 2022). Despite increasing research analysing the impacts of telemedicine in rheumatology, few studies have evaluated how the adoption of telemedicine during COVID‐19 altered other care practices in rheumatology, including the utilisation of medical imaging.…”

Section: Introductionmentioning

confidence: 94%

“…patterns of disease-modifying antirheumatic drugs, indicating that the adoption of telemedicine had clinical implications for certain care practices in rheumatology (Maheswaranathan et al, 2022). Despite increasing research analysing the impacts of telemedicine in rheumatology, few studies have evaluated how the adoption of telemedicine during COVID-19 altered other care practices in rheumatology, including the utilisation of medical imaging.…”

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confidence: 99%

Telemedicine's impact on radiologic ordering in an academic rheumatology practice

Chari,

Kellogg,

Triana

et al. 2023

Musculoskeletal Care

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“…The COVID‐19 pandemic drastically altered the way rheumatologists provide clinical care, forcing the rapid adoption of telehealth for patients with rheumatoid arthritis (RA) and other rheumatologic disorders. More than 95% of health centers across the United States offered telehealth services during the COVID‐19 pandemic ( 1 ), and reports from rheumatology practices across the globe indicate that between 40% and 90% of rheumatology encounters occurred via telehealth during the initial COVID‐19 transition ( 2 , 3 , 4 , 5 , 6 , 7 , 8 ).…”

Section: Introductionmentioning

confidence: 99%

“…Clinical scenarios for the initial survey (A-E) and modifications to scenarios C and D for the follow-up survey(1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11) …”

mentioning

confidence: 99%

Telehealth Made EASY: Understanding Provider Perceptions of Telehealth Appropriateness in Outpatient Rheumatology Encounters

Smith

Coles

Howe

et al. 2022

ACR Open Rheumatology

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Objective The purpose of this study was to evaluate a novel scoring system, the Encounter Appropriateness Score for You (EASY), to assess provider perceptions of telehealth appropriateness in rheumatology encounters. Methods The EASY scoring system prompts providers to rate their own encounters as follows: in‐person or telehealth acceptable, EASY = 1; in‐person preferred, EASY = 2; or telehealth preferred, EASY = 3. Assessment of the EASY scoring system occurred at a single academic institution from January 1, 2021, to August 31, 2021. Data were collected in three rounds: 1) initial survey (31 providers) assessing EASY responsiveness to five hypothetical scenarios, 2) follow‐up survey (34 providers) exploring EASY responsiveness to 11 scenario modifications, and 3) assessment of EASYs documented in clinic care. Results The initial and follow‐up surveys demonstrated responsiveness of EASYs to different clinical and nonclinical factors. For instance, less than 20% of providers accepted telehealth when starting a biologic for active rheumatoid arthritis, although more than 35% accepted telehealth in the same scenario if the patient lived far away or was well known to the provider. Regarding EASY documentation, 27 providers provided EASYs for 12,381 encounters. According to these scores, telehealth was acceptable or preferred for 29.7% of all encounters, including 21.4% of in‐person encounters. Conversely, 24.4% of telehealth encounters were scored as in‐person preferred. Conclusion EASY is simple, understandable, and responsive to changes in the clinical scenario. We have successfully accumulated 12,381 EASYs that can be studied in future work to better understand telehealth utility and optimize telehealth triage.

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The Impact of the COVID-19 Pandemic and Telemedicine Implementation on Practice Patterns and Electronic Health Record Utilization in an Academic Rheumatology Practice

Cited by 10 publications

References 13 publications

Factors Associated With Use of Telemedicine for Follow-Up of SLE in the COVID-19 Outbreak

Factors Associated With Use of Telemedicine for Follow-Up of SLE in the COVID-19 Outbreak

Telemedicine's impact on radiologic ordering in an academic rheumatology practice

Telehealth Made EASY: Understanding Provider Perceptions of Telehealth Appropriateness in Outpatient Rheumatology Encounters

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