Regional patients appear to be comfortable with a tele-rheumatology model of care for outpatient reviews that saves them having to travel into a major centre for most of their appointmentsa Queensland study shows. 

The tele-rheumatology service based at the Princess Alexandra Hospital, Brisbane, comprises trained nurses in regional clinics up to 700 km away who can perform joint counts and administer the RAPID 3 patient reported outcome tool. 

A rheumatologist reviews the patient via videoconferencing. All patients have stable disease across a wide range of rheumatology diagnoses and have been seen face to face at their initial consultation and subsequently at least once a year. The model does not cover patients with active or complex disease requiring more detailed physical examination and  patients on biologic bDMARD therapy.

A survey of 48 patients, published in Telemedicine and e-Health, has helped describe the patients’ perspectives on the service.  

It found patients saved about 85 kilometres on average in travel distance to their telehealth appointments compared to their face-to-face appointments. As well as saving them time and money, 42% of the participants said they didn’t have to take time off work.

And patients who had initial concerns about telehealth were won over.

Most patients (98%) were happy with the nurse preparing them for their telehealth appointment, were satisfied with the service as a whole and would attend videoconferencing appointments in the future.

“Most participants reported tele-rheumatology as equivalent to in-person care because care was thorough and the interface was similar to an in-person experience,” the study authors said. 

Senior author on the paper Dr Helen Benham said nurses and sites were enthusiastic about the telehealth service and there had been very good uptake.  

“We have a nurse at the other end. We only see routine follow-up patients. We don’t see new patients. So it’s all triaged around safe and what we think is appropriate use of tele-rheumatology.” 

She said the goal of the paper was to explore how patients felt about their telehealth consultation. 

“Is the savings, that we know everyone makes in terms of time and money and travel, translating to a good interaction for the patients with the provider? And it would seem that it does from this data.”

“People initially were not sure if they were establishing a rapport [with the clinician] but then they do. Once people start doing tele-rheumatology, they really like it. So that initial trepidation passes and they feel very comfortable.”

She said more needed to be published on tele-rheumatology.

“We do need to publish what people are doing so that the models of care can be adapted to different places,” she said.