Background/Purpose: China has no primary medical care and referral system. Patients can choose any hospitals or any doctors they like to seek medical care. As a result, most patients with rheumatic diseases rushed to a few large cities on their own cost.

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 online with mobile device. The study shows that, after training, the rheumatoid arthritis (RA) patients can master the SSDM and perform self-management, including DAS28 and HAQ evaluations, as well as medication and lab test data entries.

To evaluate the feasibility and benefit of the medical economics of online consultations based on SSDM by rheumatologists.

Methods: The rheumatologists implemented the education and training programs on using SSDM for rheumatic disease patients and assist them in downloading SSDM APP in clinic.

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 the request from their patients and practice consultation in the form of texting or telephone call.

Results: Between February 14, 2015 and June 22, 2015, 8 rheumatologists supplied 55 patients with 64 times free and 12 paid consultations. Paid consulting included 8 times text Q&A and four telephone consultations. The consulting fee ranged from RMB 50 to 300 yuan (USD:RMB =1:6.1) each in average of 220.83 ± 72.17 yuan, which rate match the registration fee in hospital. The total collection of fee for consultations was 2,650 yuan.

75% patients receiving online consultation lived in different city with the rheumatologists, the mean distance was 925.71 ± 803.65 (58 – 3,150) kilometers. 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 922.37 ± 686.94 (200 – 2,000) yuan. The total of cost for all patients would have been 70,100 yuan, which is 26.45 times compare with the cost of online. Through the SSDM system for online consultations, patients can save 96.22% of the cost. Survey shows all patients were satisfied and 87.5% of them were “very satisfied” with the consultations.

Conclusion: Using SSDM system to obtain online consultation, Chinese patients with rheumatic disease can enjoy reducing cost with high rate of 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.

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