Healthcare Providers Recognize Potential Benefits of Telemedicine in Pediatric Rheumatology During the COVID-19 Pandemic

During the coronavirus disease 2019 (COVID-19) pandemic, healthcare providers have increasingly noted the potential of incorporating telemedicine into their pediatric rheumatology practices, according to survey results presented at the American College of Rheumatology (ACR) Convergence 2020, held virtually from November 5 to 9, 2020.

The COVID-19 pandemic has forced healthcare teams to transition from in-person to virtual telemedicine visits, many of whom had limited knowledge, infrastructure, and experience. Study authors sought to collect data on the adoption of telemedicine, understand its usage, and how healthcare teams have accepted telemedicine during the pandemic.

PR-COIN, a collaborative of 20 North American pediatric rheumatology centers, conducted the current observational study by collecting data about healthcare providers’ telemedicine experience. A REDCap^® survey was sent to a representative from each site of the collaborative and the resulting quantitative data was analyzed with descriptive statistics.

Of the 19 sites that responded to the survey, all transitioned to telemedicine in response to the COVID-19 pandemic and most reported to using both telephone and videoconferencing for visits. A total of 13 (68%) PR-COIN sites reported that at least 50% of their providers documented musculoskeletal exams in patients with juvenile idiopathic arthritis by using the Gait Arms Legs and Spine Regarding telemedicine visits, 11 (58%) centers reported collecting information on pain intensity, morning stiffness, and patient global assessment. All centers reported having both new and follow-up patients over telemedicine.

Survey results showed that that height, weight, treatment targets, and disease activity were not well-documented. Two centers reported that they did not collect any patient-reported outcome measures; however, 3 centers collected more complex ones.

A total of 7 centers (37%) noted that they conducted research-related activity during virtual visits, of which 2 (29%) reported that they were able to consent patients over telemedicine. Overall, 6 (86%) sites reported that they conducted follow-up visits for observational study purposes. Of the 19 centers, 15 (79%) and 14 (74%) reported that they would be willing to see new and follow-up patients, respectively, using telemedicine.

Every center agreed on the ability of telemedicine to meet provider needs. In addition, all but 1 center agreed that telemedicine could meet patient needs.

Convenience, no travel, and continuity of care were reported to be some of the benefits of telemedicine use. Challenges included limited physical exams, access to technology, and limited ability to assess disease activity.

Study authors concluded that, ultimately, centers “supported the continued use of telemedicine after the pandemic,” and that “PR-COIN plans on identifying best practices and creating tools to address existing barriers” to its use.

Reference

Goh YI, Pan N, Harris J, et al. Telemedicine in pediatric rheumatology during COVID-19: the PR-COIN experience. Presented at: ACR Convergence 2020; November 5-9, 2020. Abstract 0597.