Telemedicine in Rheumatology at the Advent of the COVID-19 Pandemic
- PDF / 256,634 Bytes
- 4 Pages / 595.276 x 790.866 pts Page_size
- 34 Downloads / 149 Views
RESPONSE TO COVID-19/COMMENTARY
Telemedicine in Rheumatology at the Advent of the COVID-19 Pandemic Elena Gkrouzman, MD
& Dee
Dee Wu, MD & Hannah Jethwa, MD & Sonya Abraham, MBBS
Received: 26 June 2020/Accepted: 21 September 2020 * Hospital for Special Surgery 2020
Keywords
telemedicine . rheumatology . COVID-19
In late 2019, a hematologist from the University of North Carolina received a phone call from space—it was a request to evaluate an astronaut on the International Space Station who was suspected of having deep venous thrombosis (DVT). Guided by radiologists back on earth, the astronaut self-performed a tele-ultrasonography of his left internal jugular vein. Ultimately, he was diagnosed with a DVT and treated remotely [1]. Several months later, a global pandemic was declared, and practicing rheumatologists began receiving an equally important if less extraordinary alert: “Your patient has connected to video visit.” The COVID-19 outbreak affected the delivery of rheumatology services at an unprecedented level. Consequently, guidance for social distancing, and in some cases self-quarantine, prompted the expeditious uptake of remote assessments. Before the COVID-19 pandemic, tele-rheumatology was proposed to patients who needed specialist care but lived in remote areas; it was also considered a tool to address concerns for an aging workforce and a way to resolve Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-020-09810-3) contains supplementary material, which is available to authorized users. E. Gkrouzman, MD (*) : D. D. Wu, MD Division of Rheumatology, Hospital for Special Surgery, 535 E. 70th St., New York, NY 10021, USA e-mail: [email protected] H. Jethwa, MD Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridgeshire, UK S. Abraham, MBBS Imperial College London, London, UK
deficits in rheumatology specialists in the USA and other countries [3, 15]. Although telemedicine has been in the pipeline for several healthcare organizations across the globe, the pandemic dramatically accelerated its use. Given that the risk of COVID-19 infection is likely to persist, consideration is required about to how to best integrate tele-rheumatology into current models of care delivery. Remote management of rheumatologic conditions comes in many forms: from synchronous methods of videoconferencing to asynchronous methods such as “store and forward”. Additionally, remote patient monitoring systems can be a way to report patient outcomes—such as swollen joints or level of pain—between in-person visits. When examining diagnostic agreement between assessments conducted in-person versus videoconference, a systematic review found supportive evidence of reliability, especially in dermatology, where almost half of the studies were drawn from [12]. A limiting factor in such studies, however, is familiarity with baseline diagnostic variation among providers, especially when complex conditions are being assessed. In rheumatology, visits
Data Loading...
