From Survive to Thrive: A Call to Action to Transform Rheumatology Patient Care During the COVID-19 Pandemic

Bridges, Lou headshot
In this perspective, S. Louis Bridges Jr, MD, PhD, provides insight into managing care for patients with rheumatic diseases during the COVID-19 pandemic.

No event in recent history has caused such far-reaching changes within the medical industry as the ongoing coronavirus disease 2019 (COVID-19) pandemic. Similar to the virus’s ability to spread indiscriminately – infecting people regardless of age, race, or socioeconomic background – the crisis is inducing immediate, and likely permanent, changes across the entire spectrum of healthcare. Comfortable routines of healthcare delivery have been disrupted, and rheumatology healthcare professionals and patients have had to quickly adapt to the challenges posed by this sustained global pandemic. 

Now is the time to move beyond our emotions and thoughtfully explore innovative, sustainable, and scalable ways to deliver high quality rheumatology care in the safest and most cost-effective manner. If we are successful, the post-COVID era will be known as a period of great innovation that transformed the United States healthcare system. By taking advantage of every opportunity, rheumatology providers can also achieve the goal of sufficient cash flow for medical groups to continue to deliver optimal patient care. 

Even after the COVID-19 pandemic, healthcare providers should continue to comply with the fundamental principles of infection control such as the use of personal protective equipment and maintaining good hand hygiene to minimize the risk for communicable diseases. More importantly, there are many opportunities to transform healthcare delivery, which are discussed below: 

  • Optimizing the use of communication and information technologies
  • Addressing health disparities in rheumatic disease care for underserved populations
  • Expanding global collaborations to share information and best practices across countries

The optimization of communication and information technologies includes both innovative uses of existing technologies and incentivizing creation of new technologies. The use of telehealth, which expanded exponentially during COVID-19, should continue to provide outpatient care for patients with stable disease activity and are unable or unwilling to travel. Because of commute time and loss of outpatient revenue, fewer community-based rheumatologists provide inpatient consults at hospitals. Should this trend continue, hospitals can contract with rheumatologists to provide telehealth services for hospitalized patients.  

The use of mobile technologies, such as smartphones and other handheld devices, can provide great opportunities for patients to communicate symptoms to providers and also for the transfer of information on physical activity levels and other biological parameters into electronic health records. In addition, handheld devices or personal computers can be great avenues for patient education. 

The global pandemic has also highlighted the health disparities that have persisted in the United States for decades. Now is the time to aggressively address social determinants of health, which have resulted in poorer outcomes for African American and Hispanic patients with rheumatic diseases. Continued parity for audiovisual and audio-only telehealth evaluation and management visits will support broader access to care for patients in rural and underserved areas without access to the technologies required for video. 

Finally, global collaborations to share information and best practices across countries have arisen as a result of COVID-19, such as the Global Rheumatology Alliance. Continuing and expanding such efforts to share information can result in the adoption of best practices across counties, as well as highlight the need for specific geographic or population-based programs to optimize the care of patients with rheumatic diseases. 

The development of many of these innovations is dependent on the availability of research funding to demonstrate that they improve patient outcomes and to assess feasibility and cost-effectiveness.

As the largest private funding source for rheumatology research and training in the United States, the Rheumatology Research Foundation is dedicated to providing funding for highly innovative ideas that advance treatment options, improve care, and affect the lives of the 54 million Americans living with rheumatic disease. In our most recent fiscal year, the foundation distributed almost $11 million in grant awards focused on research and workforce development within the field of rheumatology. Amid the economic crisis accompanying the global pandemic, the foundation intends to fund grant applications to explore the relationships between COVID-19 and rheumatic and musculoskeletal disease.

Let’s work together to provide hope and action and make the COVID-19 pandemic a watershed moment rather than a lost opportunity to transform care for patients with rheumatic diseases. 

Editor’s Note: S. Louis Bridges Jr, MD, PhD is the president of the Rheumatology Research Foundation and director of the Division of Clinical Immunology and Rheumatology at the University of Alabama at Birmingham. This opinion piece was contributed by the author and has been edited for style.