Background/Purpose: Telemedicine (TM) is the delivery of health care services using information and communication technologies. TM presents unique opportunities and benefits specifically in rheumatology as most rheumatic illnesses are chronic requiring frequent disease monitoring, outpatient therapies, and a strong patient-physician relationship. This study aims to assess the patients’ ability and willingness to utilize telemedicine along with some of the barriers to a more widespread adoption of TM in rheumatology.

Methods: A cross sectional survey of patients visiting a rheumatology clinic in Florida from March-August 2018 was conducted. We used a Tele-Rheumatology Questionnaire to assess patients’ attitude on the effectiveness of TM versus in-person visits, patients’ access to technology (telephone, front facing camera, and high-speed internet), distance traveled by the patient to attend the clinic visit, and demographic parameters (age, sex, race, new patient vs follow-up, and diagnosis). Data was analyzed using Statistical Package for Social Sciences and descriptive statistics were calculated.

Results: 214 rheumatology patients participated in this study. 82.7% were women and 17.3% were men with an average age of 58.3 ±13.5. We found statistically significant associations between age and the following responses: access to—front facing camera (mean difference -12.8), —telephone (mean difference -14.4), and —stable internet connection (mean difference -15.1); conflict in appointments and work hours (mean difference -11.73); willingness to—utilize telephone consultation (mean difference -3.97) or —live video consultation (mean difference  -8.09); —try TM with a new rheumatologists (mean difference -7.82); —try TM with an established rheumatologist (mean difference -11.19); —try TM for other specialties (mean difference -8.16); —try TM to reduce time between appointments (mean difference -10.79).

Follow-up patients were more likely to feel that their visit could have been possible over the phone (mean difference -1.13) or video conferencing (mean difference -1.13) compared to new patients.

Older patients were less likely to think that the purpose of their rheumatology visits could be achieved over the phone (r-.207, p=0.003) or video conferencing (r -.331, p=0.001). Negative correlations were found between increase in age and believing that their needs could be met through TM (r -.224, p< 0.001) and thinking that TM could be an appropriate alternative method of healthcare (r -.298, P< 0.001).

The further the distance traveled, the more the patients were willing to utilize telephone consultation compared to in-person visits (r 0.167,p=0.019).

Conclusion: With the COVID-19 pandemic, rheumatology clinics are increasingly turning to TM as the main, and sometimes only, method of seeing patients. The results of this study suggest that technology may still be limited in certain demographics, particularly the elderly. This study helps to understand some of the limitations of TM that can be crucial in the development of solutions to make it a better option for all rheumatological patients. Futures studies are needed to evaluate if this sample population felt the same once telehealth was actually utilized. 

Left: Statistically significant correlation between age and patients who responded that the purpose of the clinic visit could have been possible over telephone, in which a negative correlation of -0.207 (p=0.003) was seen. Right: statistically significant correlation between age and patients who responded that the purpose of the clinic visit could have been possible over video conference, in which a negative correlation of -0.333 (p < 0.001) was seen.

Left: Statistically significant correlation between age and patients who responded that their needs could have been met with telemedicine, in which a negative correlation of -0.224 (p < 0.001) was seen. Right: Statistically significant correlation between age and patients who responded that telemedicine could be an appropriate method of healthcare, in which a negative correlation of -0.298 (p < 0.001) was seen.

Statistically Significant correlation between age and “yes and no” questions on the TRQ. The mean difference in age between 1 and 2 = -12.837 (p < 0.001), between 1b and 2b = -14.417 (p < 0.001), between 3 and 4 = -15.107 (p < 0.001), between 5 and 6 = -11.733 (p < 0.001), between 7 and 8 = -3.973 (p < 0.040), between 9 and 10 = -8.099 (p < 0.001), between 11 and 12 = -7.826 (p < 0.001), between 13 and 14 = -11.193 (p < 0.001), between 15 and 16 = -8.167 (p < 0.001), between 17 and 18 = -10.797 (p < 0.001).

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/ability-and-willingness-to-utilize-telemedicine-among-rheumatology-patients-a-cross-sectional-survey/