Evaluation of the Impact of Telemedicine on Management of Rheumatoid Arthritis (Alaska)

Project Details - Ongoing

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Summary:

Rheumatoid arthritis (RA) is a chronic autoimmune disease predominantly affecting joints, leading to high rates of disability and increased mortality. Guidelines for treatment of RA require frequent visits to a rheumatologist. American Indian and Alaska Native (AI/AN) populations have a high burden of RA. In the United States, there is a shortage of rheumatologists that disproportionately affects minority and rural populations, including AI/AN populations. Improving access to rheumatologists to those with RA is expected to improve the quality of care for these patients.

The Alaska Tribal Health System has been a leader in telemedicine innovation. The system began with a robust store-and-forward mode of telehealth, but now, as broadband capability has improved, video teleconference (VTC) capability in multiple Alaska clinics has grown exponentially. This VTC technology is improving access to care, including to rheumatologists, for AI/AN patients. It is also expected to improve quality of care, as rheumatologists are able to see their patients more frequently. This project will evaluate the impact of telemedicine rheumatology via VTC followup on outcome and process measures of quality of care for RA patients within the Alaska Tribal Health System.

The specific aims of the project are as follows:

  • Determine the impact of telemedicine on disease activity, a patient-centered outcome measure of quality of care for RA 
  • Investigate the impact of telemedicine on process measures of quality of care for RA

The project will enroll a prospective cohort of RA patients seen by a rheumatologist with or without telemedicine VTC followup. Quantitative and qualitative methods will be used to evaluate usefulness, usability, and the impact of VTC. Evaluation findings have the potential for generalizability to other populations with geographic or other barriers to health care access.

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