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Use of Telehealth in Rheumatology

Use of Telehealth in Rheumatology

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American College of Rheumatology Meeting, Washington DC:

I've had the good fortune to be invited to give a presentation at the annual scientific meeting for rheumatology (thanks to Carlo Caballero, @carvicab for the invite & thanks to Claire Barrett for help with the slides).

My first talk at this meeting so I'm feeling some nerves mixed with some excitement.

Unusually for me, the topic is telehealth, as it relates to rheumatology.

Telehealth involves the provision of remote consultations (ie when patient & provider are not in the same consulting room) using some form of telecommunication.

Think email, video chats, even the humble telephone call.

Specifically, I am going to discuss the Australian experience with video consultation.

This is particularly relevant in rheumatology where there is a clear maldistribution of rheumatologists, with the vast majority based in a handful of cities.

Telehealth is clearly an important tool to improve access to care, to provide convenience, and to potentially reduce cost of care. There are issues and difficulties to consider but these should be surmountable.

While we're still in relative infancy with the use of telehealth consultation in Australia with less than 1% of medical consultations in this form, things should change.

It requires realignment of incentives. Our payer, Medicare, reimburses telehealth when there is a distance imperative, when patients live in some region deemed far away enough from specialist care.

This is a good start to try and reduce the tyranny of distance. However, it ignores the bulk of the population and limits the potential for telehealth to really change how we deliver health care, and perhaps, improve outcomes.

If there is some reimbursement on a much broader scale, such as involving all our patient consultations, you'll see much wider uptake. And this will likely lead to efficiency, improved care and convenience. Less wasted time in traffic. More immediate access to medical knowledge which may allay fear and avert unnecessary investigation and/or suffering and/or further waste of resources.

My disclosure is that I want this to happen.

My multiple phone calls to patients, the email exchanges, the "quick" advice provided on the run, this work done after routine clinic hours, are all currently not reimbursed.

I'd like one day to provide consultations to my patients, from anywhere in the world, for example, when I'm away on conference or if I ever get to take a 3 month sabbatical.

It will be good for me. And I think it will be good for my regular patients, who I know well and who know me well.

The talk should be relevant for those interested in understanding or in providing telehealth consultation.

For those at the ACR meeting, it's on Tuesday 15th 2.30pm at the ILAR Session: Innovative Solutions to Deliver Care. 

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