Don’t Be Afraid to Engage: Health Technologies for Patients & Rheumatologists

SINGAPORE—In the first quarter of the 21st Century, the world of medicine has seen an explosion in health technologies, many of which have the potential to greatly impact patients’ lives.

At the 26th Congress of the Asia Pacific League of Associations for Rheumatology (APLAR) in August 2024, Rebecca Grainger, MBChB (Dstn), BMedSci (Dstn) MIsntD, FHiNZ, FRACP, PhD, professor, Department of Medicine, Te Whatu Ora Capital Coast and Hutt Valley, University of Otago, Wellington, New Zealand, gave a lecture titled, Health Technologies and Patient Engagement. She described new technologies and presented the evidence for how such interventions may help improve outcomes in rheumatology and make patients feel more involved in their medical care.

Dr. Grainger began by answering the question: “What is personalized care?” In her words, personalized care is a system in which information, such as a patient’s unique biology, their individual needs, their preferences and social circumstances, can be used to ensure care is tailored specifically to that patient.

The application of personalized care can occur at different time points, including the point of access, when questions of diagnosis and management arise, and when patients are followed over time. Regarding access, Dr. Grainger noted that demand for rheumatologists outstrips supply; thus, getting the right patients in for an evaluation at the right time is key. Delays often occur at four main points:

• After the initial onset of symptoms;
• After the first evaluation by a primary care provider;
• After the first appointment with a rheumatologist; and
• The point at which a diagnosis can be secured, and a treatment plan can be implemented.

Symptom Checkers & Diagnosis

Rheumatology faces a challenging conundrum: Many patients with inflammatory rheumatic diseases encounter obstacles to seeing a rheumatologist in a timely manner, yet up to 60% of patients who see a rheumatologist for rheumatic complaints are not ultimately diagnosed with an inflammatory rheumatic disease.^1,2 Thus, room exists for help from online symptom checkers, which are patient-facing, diagnostic, decision-support systems. In some cases, such tools may reduce delays in care and errors in diagnosis, helping triage patients appropriately.

Through the work of The Joint Pain Assessment Scoring Tool (JPAST) project, a European initiative aimed to enable and accelerate precision medicine for early treatment in rheumatology, researchers have developed an online symptom checker named Rheumatic?. To date, Rheumatic? has demonstrated high discriminative performance in identifying patients likely to develop rheumatoid arthritis (RA) in an at-risk population and in differentiating inflammatory rheumatic diseases from other musculoskeletal conditions in people with early joint swelling.³