Telerheumatology – Patient perspectives on using telemedicine for the management of inflammatory arthritis

S Devadula1,2, H Benham3,4

1 Rheumatology Advanced Trainee, Princess Alexandra Hospital, Woolloongabba, QLD,Australia

2 Associate Lecturer, University of Queensland, Brisbane,QLD,Australia

3 Staff Specialist Rheumatologist, Princess Alexandra Hospital, Woolloongabba, QLD,Australia

4 NHMRC Research Fellow, Translational Research Institute, Woolloongabba, QLD,Australia

 

Background

Telemedicine is the use of advanced telecommunication technologies to exchange health information and provide health care services across geographic, time, social and cultural barriers. Telemedicine offers the potential to utilize new technologies to provide better access to health care including access to specialist services that might otherwise not be available without extensive travel. Research from the early 1990s has confirmed that telemedicine is an efficient mode of quality healthcare delivery, for patients who are unable to access health care due to geographical and/or personal resource barriers.

For telemedicine to be effective, it must increase access to care, while providing health services that simulate key activities for adequate clinical assessment, such as a history and physical examination. A limitation in the existing telemedicine literature is the lack of studies examining patient acceptability and perspectives of telemedicine encounters. These go beyond ‘patient satisfaction with a telehealth service’, traditionally viewed as easier access to specialists, reduced travel time and financial savings. Patient perspectives are crucial to allow the development of patient centered telerheumatology care.

Objectives

To execute research project that will (1) enable providers to gain an understanding of the patients’ perspectives of the quality attributes of telerheumatology for the management of inflammatory arthritis; (2) investigate the relevance and significance of differential patient perspectives and; (3) work towards strategic improvements in the delivery of telerheumatology, targeting better health care access and patient outcomes.

Aims

1)To perform a cross sectional prospective quantitative and qualitative research study examining patient perspectives of telerheumatology service at Princess Alexandra Hospital to the “ hub sites” of Toowoomba, Ipswich, Beaudesert and Roma Hospitals.

2) Utilise the data to develop a patient centred framework for the coordinated delivery of telerheumatology.

Methods

The study progresses in two phases. During the quantitative phase, all the patients with inflammatory arthritis reviewed in the telerheumatology clinics will be invited to participate in a patient survey broadly covering their perspectives on quality of care delivered, advantages and disadvantages, preferences for telehealth versus face to face appointments, physician patient interaction, cultural barriers/ facilitators and willingness to participate in telerheumatology mediated delivery of patient education.

During the qualitative phase, selected patients who have consented to being contacted, will be invited to participate in small focus group sessions to provide data on patient centred telerheumatology. The focus groups will be lead by a research moderator. The assessments are based on previous qualitative designs.

Significance

There is extensive evidence that telehealth can be cost saving, time saving as well as patient satisfying. Our study aids to provide an evidence for a telerheumatology based approach to improve current models of care targeting rural and regional Australians.

Disclosures

S Devadula is the Registrar Bursary Grant Recipient from Arthritis Queensland 2015.