“Having a data management or informatics person may not be necessary for a small practice,” Dr. Shah says, “but there may be a need for a physician to have some expertise [in this field] and take the lead by having protected time [for] that role. I think most rheumatology practices would start [this informatics position the] same way they have someone manage their infusion center.”
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More Tech, More Data
Wearable technologies, such as Fitbit or Apple Watch, are a cutting-edge way to gather data in out-of-office settings, Dr. Curtis says.1 Clinics can invest in software to collect data, and some studies are even providing such wearable technologies to patients.
“It’s the future, but it’s not enough to get more data merely for the sake of having more data,” he says. “Interpretation and value need to be attached to the data to help clinicians. When it comes to data, more isn’t better, and sometimes, it’s worse if the data aren’t made useful.”
Dr. Shah agrees wearables are cool and proving useful in both research and clinical practice, but he too stops shorts of labeling them a panacea.
“With everyone now having a smartphone or watch, and having them on all the time, collecting those data in real time can allow rheumatologists to better tune our treatments, as opposed to getting a snapshot of the disease activity once every three to six months,” he says. Dr. Shah also notes wearable technology’s potential to enhance patient-physician communication with patient portals. “I think investing in these types of technologies can really help patients engage themselves.”
Dr. Shah says he can envision a coaching app that assists patients with pain management. Such an app could be programmed to encourage patients with alerts—“Hey, you’re doing a great job!” —or with reminders—“Your exercise has dropped off in the past week.”
“I think that’s sort of the future,” he says. “I’m not quite sure where they’re at now, but a number of pain specialists have looked to these technologies, even such things as virtual reality, to improve pain management in diseases like osteoarthritis, which we don’t have a lot of drugs or medications to treat.”
Virtual House Calls
Telemedicine is another opportunity for investment, one that Dr. Shah says has “incredible potential” to improve access to rheumatology services. Only 12.6% of physician practices in the U.S. have used telemedicine.2
“There is a growing gap between [the number of] patients who need rheumatologists and the number of rheumatologists—and the closing of that gap is nowhere in sight. Particularly in rural areas and even in urban and suburban areas, the wait time to see a rheumatologist is often months,” he explains. “Some EHR systems really facilitate telehealth.”