Background/Purpose: China does not have primary medical care and referral system. Patients can choose any hospital or any doctor they like to seek medical care. As a result, most patients with rheumatic diseases rushed to a few large cities. Survey shows more than 40% of the rheumatic disease patients are unnecessary to go to hospital and they only need advices from specialist. Smart System of Disease Management (SSDM) is a series of applications for chronic diseases management, which develop the interaction between doctors and patients. The study shows that, after training, the RA patients can master the SSDM and perform self-management, including DAS28 and HAQ evaluations, as well as medication and lab test data entries. The purpose of this study is to evaluate the feasibility and benefit of the medical economics of online consultation based on SSDM by rheumatologist.

Methods: The rheumatologists and nurses implemented the education and training programs on using SSDM and assisted the patients in downloading SSDM APP. The SSDM includes doctors’ application and patients’ application. The patient application includes self-assessment (DAS28, HAQ), medication management, adverse events management and laboratory records. After data entry, patients can synchronize data to the authorized doctor. On the basis of understanding of the disease activities, medication and laboratory test results, the rheumatologists can accept consultation request from the patients and supply them with advices in forms of text and or telephone call.

Results: Between February 14, 2015 and June 12, 2016, 30 rheumatologists supplied 132 patients with 136 times free and 55 paid consultations. In which there were 176 times text Q&A and 15 telephone consultations. Paid consultation included 43 times text Q&A and 12 telephone consultations. The consulting fee ranged from RMB 50 to 500 yuan (USD:RMB =1:6.6) each in average of 275.45 ± 90.20 yuan, which rate match the registration fee in hospital. The total fee for consultations was 15,150 yuan. 75.8% patients receiving online consultation lived in different cities with the rheumatologists. If patients seek medical in hospital, in addition to the registration fees and medical expenses, the mean cost of transportation, accommodation, meals and lost wages was 1081.68 ± 523.28 (200 to 1,800) yuan. The total of cost for all patients would have been 248,250 yuan, which is 15.38 times higher than online consultation. SSDM can save up to 93.90% cost for patients. Survey shows all patients were satisfied and 64.86% of them were “very satisfied” with the consultation services.

Conclusion: Using SSDM system to obtain online consultation, Chinese patients with rheumatic disease can enjoy reduced cost with high satisfaction. In the era lack of primary care system in China, SSDM may serve a complimentary platform to control medical care cost, as well as relieve the tensions between health care professionals and patients.

« Back to 2016 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/online-consultation-for-chinese-patients-with-rheumatic-diseases-based-on-smart-system-of-disease-management-ssdm-mobile-tools-a-study-of-medical-economics/