Background/Purpose: The national shortage of rheumatology clinicians disproportionately affects over 2.7 million rural Veterans with already limited access to healthcare. To address this gap, the National Tele-Rheumatology Program (NTRP) was developed to connect Veterans with rheumatologists via telehealth. This study aimed to evaluate veteran patient satisfaction with the NTRP using a convergent mixed method analysis.

Methods: We invited a random sample of Veterans who had at least 1 rheumatology encounter via the NTRP to participate in telephone surveys. The first group completed the Telemedicine Satisfaction Questionnaire (TSQ), a validated 14-item instrument assessing quality of care, interaction, and satisfaction. The second group provided qualitative feedback through brief open-ended questions about the NTRP (“What are things that you liked about the program?” and “What are things that you did not like about the program?”). Quantitative data were analyzed using descriptive statistics and qualitative data were analyzed using a multi-stage thematic approach. Data were integrated through joint display analysis framed by the Healthcare Quality Framework (HQF), including domains of safety, patient-centeredness, effectiveness, efficiency, timeliness, and access and equity.

Results: A total of 160 patients responded to the TSQ (86.9% male, mean (SD) age 63.3 (14.7)). Responses reflected moderate to high satisfaction across all survey items (Table 1). 102 patients responded to the open-ended questions (79.4% male, mean (SD) age 63.8 (14.6)). Major themes and corresponding quotes are shown in Table 2: Veterans expressed high overall satisfaction with the NTRP, highlighting effective treatments, strong coordination, and the convenience of remote care. Many valued the program’s efficiency, safety, and time-saving benefits. However, concerns emerged around technical difficulties, limited visit duration, and the absence of physical examinations. A subset of patients also preferred in-person care, underscoring the need for a tailored approach. The joint display analysis, framed by the HQF (Table 3), revealed concordant findings from the survey and open-ended questions, though the TSQ was limited in capturing negative perceptions towards the program around safety and timeliness.

Conclusion: Overall, Veterans reported high satisfaction with the NTRP, especially in domains of quality, effectiveness, and efficiency. Moving forward, efforts should aim to streamline logistics and refine patient selection to ensure telehealth is matched to clinical need and individual preferences. These findings can help inform future telehealth program design and implementation across other specialties serving rural populations.

Table 1: Tele-Medicine Satisfaction Questionnaire Scores for random sample of Veterans participating in the NTRP (N&#3f160)

Table 2: Generated themes with exemplary quotes according to the Healthcare Quality Model (n=102)

Table 3: Joint display analysis according to the Healthcare Quality framework

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/patient-perceptions-of-the-national-tele-rheumatology-program-a-mixed-methods-study/