Telehealth Extends Rheumatology Care

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Many arthritis patients live in areas where there are no local rheumatologists. Making matters worse, an ongoing physician workforce shortage is projected to worsen in the next decade, lengthening wait times and making appointments harder to come by.

A project funded by the Rheumatology Research Foundation’s Clinician Scholar Educator Award will expand the reach of telehealth even further, training rheumatologists and other care providers in telehealth skills—and exploring how telehealth could help clinicians bridge widening gaps in healthcare access.

“Clinical medicine is advancing beyond the bedside, making the ‘webside’ a new priority,” said lead investigator Marcy Bolster, M.D., director of the Rheumatology Fellowship Training Program at Massachusetts General Hospital (MGH) in Boston. “Clearly, innovation is needed to expand access to care.”

“The fact that we can get on Zoom within our own electronic medical record system and it’s a HIPAA-compliant virtual platform is incredibly helpful in our work,” Dr. Bolster said.

Dr. Bolster has been involved in rheumatology medical education and fellowship training throughout her career. While physicians often cannot treat patients across state lines because of licensing concerns, telehealth potentially bridges that gap. Doing so, however, requires a unique set of skills. “What better time to train people to use telehealth technology than as they enter the workforce?” she said. “We must prepare them to be effective and competent practitioners in rheumatology telemedicine.”

Although telehealth is expanding rapidly in many areas, formal telehealth education is not currently a part of many rheumatology fellowship training programs.

In addition to creating curricular components for rheumatology fellows to develop competency in the delivery of telehealth, Dr. Bolster is collaborating with the Indian Health Service, an early adopter of telehealth services, and primary care providers at Rosebud Indian Reservation in South Dakota to develop a “train-the-trainer” program in rheumatology telemedicine. Participating MGH rheumatology fellows lead a monthly didactic series comprising case-based educational sessions on rheumatic disease care to primary care providers at Rosebud.

“This is an important training opportunity for our rheumatology fellows, who now can be better prepared for the future landscape of rheumatic disease care,” Dr. Bolster said. “This award will help us deliver more effective care for all rheumatology patients, including those who may not otherwise have had this access.”

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