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EP-118 - Telemedicine for Rheumatoid Arthritis in Alaska Native People: Impact on Outcomes, Quality and Satisfaction

Monday, April 30
4:45 PM - 5:00 PM
Location: Education Zone, Booth 2416, Screen 1

Rheumatoid arthritis (RA) is an autoimmune disease with a high prevalence in Alaska Native and American Indian populations. In RA, frequent visits to a rheumatologist improve disease outcomes. In the Alaska Tribal Health System, there has been rapid uptake of telemedicine using video teleconference by specialty clinics including rheumatology. Few studies have assessed the use of telemedicine for RA. The purpose of this session is to provide data from an ongoing research study evaluating the impact of telemedicine rheumatology follow-up on disease activity, access to care, and quality of care in RA. In addition, the study is examining views about telemedicine with a participant survey. Individuals with a diagnosis of RA seeing a rheumatologist for follow-up either in-person or by telemedicine, both of which are offered as part of usual care, were invited to participate in this study. Participants completed a telemedicine survey, the RAPID3 (a self-reported rheumatoid arthritis disease activity questionnaire), and agreed to medical record review for demographics, disease characteristics, and quality of care measures. Participants are being contacted at 6 and 12 months for follow-up surveys. For data analysis, participants are categorized as being in the telemedicine group if they have had at least one telemedicine visit with a rheumatologist and in the in-person group otherwise. To date, 92 participants with RA have enrolled in the study. Additional enrollment is expected prior to this presentation. At baseline, demographics, disease activity and functional status were similar in the telemedicine vs. in-person groups. The telemedicine group had more visits with a rheumatologist in the past year (mean 3.3 vs. 2.3, p=0.002). Disease activity and functional status were documented in the medical record more commonly in the in-person group (p=0.011 and 0.018, respectively), but there was no difference in other quality measures. The telemedicine group was more likely to have favorable opinions about several aspects of telemedicine, and the majority (71%) felt that the medical care they receive in telemedicine visits is as good as in-person care. In summary, at baseline, the characteristics of study participants with RA who have been seen by telemedicine are similar to those seen in-person. However, participants ever seen by telemedicine have more frequent visits with a rheumatologist, which is likely to result in improve long-term disease outcomes. In addition, those seen by telemedicine have more favorable opinions of telemedicine than patients seen in-person only. Longitudinal data collection is ongoing and will be available by the time of the presentation.

Learning Objectives:

Elizabeth D. Ferucci

Rheumatologist/Medical Researcher
Alaska Native Tribal Health Consortium

Dr. Ferucci is a rheumatologist and clinical researcher with the Alaska Native Tribal Health Consortium. Her research has focused on the epidemiology of autoimmune diseases in Alaska Native and American Indian people, especially systemic lupus erythematosus and rheumatoid arthritis which are present at high rates in these populations. In addition, she has studied quality of care in rheumatoid arthritis and currently has an AHRQ-funded grant evaluating the impact of telemedicine on management of rheumatoid arthritis. Dr. Ferucci received her undergraduate degree at Columbia University, MD from New York University School of Medicine, MPH from the Johns Hopkins Bloomberg School of Public Health, and completed her internal medicine residency and rheumatology fellowship at the University of Colorado Health Sciences Center in Denver.

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Sarah Freeman

Director of Telehealth Program Development
Alaska Native Tribal Health Consortium

Sarah Freeman, PharmD is the Telehealth Program Development Director at the Alaska Native Tribal Health Consortium. Her role is to help develop the clinical programs and processes to deliver healthcare to more than 180 rural tribal health clinics via telehealth technologies across the state of Alaska. She has facilitated the successful deployment of over 20 new telemedicine clinical specialty and primary care services to tribal sites across the state of Alaska. Dr. Freeman is a pharmacist by training and has had a diverse health care background in population health, oncology research, clinical program development, healthcare quality and performance improvement, prior to settling into telemedicine. Dr. Freeman received her Pharmacy degree from the University of California, San Francisco, and completed her residency practice at Kaiser Permanente, San Diego.

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