“When COVID-19 happened earlier this year, we had to respond. I had to keep in mind that our teleconsult centers were located in rural areas. Many primary-care physicians’ offices closed. We became a main source of information for patients about COVID-19,” Dr. Peoples said. “There was also a shift from patients going into teleconsult centers to receiving care at home through telephone visits or home video visits through an app in our EMR [electronic medical record] interface.”
Dr. Peoples acknowledged telerheumatology’s limitations in her program, including the inability to perform procedures or infusions, and it may not be appropriate for diagnosis or new patient visits. New equipment or platforms may be costly for practices or even large systems. However, it has been a helpful option for delivering care to both rural patients and those who need to stay home due to the risk of COVID-19 exposure. Rheumatologists who are considering ramping up their telehealth services must consider the investments in equipment or staff training required, as well as the telehealth coverage policies of payers in their region, she said.
“Is telerheumatology sustainable where you are? Remember that it’s a dynamic process. You collect regular feedback about your program and adjust workflows as needed. Think about clinical support you may need, such as where patients will go for diagnostic testing or infusions.” Consider how to coordinate multidisciplinary televisits with other specialists if needed for complex cases, she said.
Rheumatology programs must train more fellows in telehealth to prepare for the growing demand for remote care, Dr. Peoples said. “In the future, telerheumatology will be one of many options to provide the right care to the right patient at the right time and place.”
Susan Bernstein is a freelance journalist based in Atlanta.
References
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- S. Centers for Medicare & Medicaid Services. Medicare telemedicine health care provider fact sheet. 2020 Mar 17.
- Mehrotra A, Chernew M, Linetsky D, et al. The impact of the COVID-19 pandemic on outpatient care: Visits return to pre-pandemic levels, but not for all providers and patients. The Commonwealth Fund. 2020 Oct 15.
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- Committee on Rheumatologic Care, American College of Rheumatology. Position Statement on Telemedicine. 2020 Sep.
