Reducing the time to diagnosis and initiation of appropriate treatment is paramount to intercept inflammatory damage in patients at the onset of rheumatic disease. But those targets can be delayed by provider shortages and other barriers to care. Since last June, Remission Medical, a virtual rheumatology clinic, has been partnering with Mayo Clinic to find ways to address those barriers.
Their agreement aims to further develop earlier time-to-treatment initiation in rheumatology and to increase predictive patient care. Now in its pilot study phase, the Remission Medical/Mayo Clinic collaboration will leverage patient-reported outcomes and clinic metrics with remission status, employing artificial intelligence (AI) and machine learning, to develop algorithms and predictive software to triage patients with telehealth and facilitate timely interception when symptoms are exacerbated, potentially avoiding urgent care and emergency department visits.
John Davis III, MD, vice chair and practice chair for the Division of Rheumatology at Mayo Clinic, says, “We are facing a critical shortage of rheumatologists, leading to gaps in access to care. It is paramount to provide access to care for people with rheumatic and musculoskeletal diseases living in underserved communities in the U.S., especially in rural areas.”
A Personal Investment
Closing the gaps in care and sustaining continuity in care during remission are issues that compelled Blake Wehman, MHA, to found Remission Medical. In fact, the genesis of Remission Medical was personal for him. Mr. Wehman’s experience with what he calls “navigating the labyrinth of rheumatology” pushed him to question whether it was possible to develop a better model to maintain remission for those with rheumatic conditions.
Mr. Wehman
At age 20, Mr. Wehman developed symptoms that were attributed nearly a year-and-a-half later to adult-onset, undifferentiated inflammatory arthritis. Finding his way to diagnosis through initial bouts of high fevers and pain, and then to remission, has been nearly a 10-year process.
After college—where he pursued a degree in healthcare management—he also moved several times, experiencing what are typical wait times for finding a new rheumatologist. He cycled through many treatments—etanercept (Enbrel), abatacept (Orencia), infliximab (Remicade), adalimumab (Humira)—before finally being prescribed the interleukin-6 inhibitor tocilizumab (Actemra). Although that medication worked for him, prior inflammation had already rendered his left hip damaged, requiring a total hip replacement. In Mr. Wehman’s mind, the need to go beyond the model of reactive response (i.e., using pain, inflammation levels and lab reports to direct care) led to a vision of building a novel composite picture of each patient’s true remission status.
