Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Aug 21, 2020
Date Accepted: Mar 4, 2021
Date Submitted to PubMed: Mar 17, 2021
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Acceptance of Telerheumatology: Results of a nationwide Survey of Rheumatologists and General Practitioners
ABSTRACT
Background:
The worldwide burden of musculoskeletal diseases is increasing. The number of newly registered rheumatologists has stagnated. Primary care, which takes up a key role in early detection of rheumatic disease is working at full capacity. COVID-19 and its containment impede rheumatological treatment. Telemedicine in rheumatology (telerheumatology) could support rheumatologists and general practitioners.
Objective:
To investigate acceptance and preferences related to the use of telerheumatology care among German rheumatologists and general practitioners.
Methods:
A nationwide cross-sectional, self-completed, paper-based survey on telemedicine in rheumatology care was conducted among outpatient rheumatologists and general practitioners (pre-COVID-19).
Results:
A total of 73% (349/476) of survey participants rated their knowledge of telemedicine as unsatisfactory, poor, or very poor. The majority of survey participants (358/480, 75%) answered that they do not currently use telemedicine, although 62% would like to (291/467). Barriers to the implementation of telemedicine include the purchase of technology equipment (182/292, 62%), administration (181/292, 62%) and poor reimbursement (156/292, 53%). Seventy percent (117/168) of the surveyed physicians reckoned telemedicine could be used in rheumatology. Surveyed physicians would prefer to use telemedicine to communicate directly with other physicians (370/455, 81%), than to communicate with patients (213/455, 467%). Among treatment phases, 64% of participants would choose to use telemedicine during ‘follow-up’ (291/452). Half of the participants would choose 'telecounseling' as a specific approach to improve rheumatology care (91/170, 54%).
Conclusions:
Before COVID-19 appeared, our results indicated generally low use but high acceptance of the implementation of telerheumatology among physicians. Participants indicated that the lack of a structural framework was a barrier to the effective implementation of telerheumatology. Training courses should be introduced to address the limited knowledge of physicians in the use of telemedicine. More research into telerheumatology is required. This includes large scale RCTs, economic analyses and the exploration of the user preferences.
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