Background/Purpose: Technological advances have facilitated the use of nontraditional forms of health care encounters, such as telemedicine.  The aim of this study was to describe our experience using telemedicine for the evaluation of new patients referred to the Rheumatology Clinic at the Palo Alto VA.

Methods: This is a descriptive study of the initial rheumatologic evaluation using telemedicine conducted as a VA quality assurance project.  Patients  were seen at a community based outpatient clinic by a nurse practitioner (KH) with a Rheumatologist (ML) participating in the encounter via Telelink from our primary site.   Patients completed a satisfaction survey immediately after this initial telemedicine encounter.  All patients had a second visit in person with the same Rheumatologist (ML) at the primary site.  A subsequent telephone survey was conducted by a different provider (TNO) to assess patient satisfaction with both telemedicine and in-person care methods.  Patients were also asked if they had a preference for one or the other care method.

Travel data (mileage) were also collected for both visits.

Results: 37 patients underwent the initial telemedicine evaluation.  All of these had a second in person Rheumatologist visit and completed both questionaires. Ten had  chronic autoimmune conditions such as inflammatory polyarthritis, polymyalgia rheumatica , systemic lupus erythematosus, and ankylosing spondylitis; five had crystal arthropathies.  The remaining 22 patients had non-inflammatory musculoskeletal conditions.  Travel miles were less for all participants for the telemedicine visits relative to the in person visit with the Rheumatologist at the primary site.

Immediately after the telemedicine encounter, all patients gave a 10/10 rating for satisfaction.  During the telephone survey after their in person visit with the Rheumatologist, 30 remained highly satisfied with the telemedicine encounter, 10/10. However, among patients with chronic inflammatory conditions or crystal arthropathies, 66% (10/15) preferred the in person visit.  Among patients with non-inflammatory conditions 41% (9/22) preferred the in person visit with the Rheumatologist.

Conclusion: Satisfaction with telemedicine visits was high, but patients with chronic inflammatory disorders or crystalline arthopathies preferred the in-person visits, despite greater travel distances

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/satisfaction-with-the-initial-evaluation-for-a-rheumatologic-complaint-using-telemedicine/