1
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Recommendation to implementation of remote patient monitoring in rheumatology: lessons learned and barriers to take

      discussion

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Remote patient monitoring (RPM) leverages advanced technology to monitor and manage patients’ health remotely and continuously. In 2022 European Alliance of Associations for Rheumatology (EULAR) points-to-consider for remote care were published to foster adoption of RPM, providing guidelines on where to position RPM in our practices. Sample papers and studies describe the value of RPM. But for many rheumatologists, the unanswered question remains the ‘how to?’ implement RPM.

          Using the successful, though not frictionless example of the Southmead rheumatology department, we address three types of barriers for the implementation of RPM: service, clinician and patients, with subsequent learning points that could be helpful for new teams planning to implement RPM. These address, but are not limited to, data governance, selecting high quality cost-effective solutions and ensuring compliance with data protection regulations. In addition, we describe five lacunas that could further improve RPM when addressed: establishing quality standards, creating a comprehensive database of available RPM tools, integrating data with electronic patient records, addressing reimbursement uncertainties and improving digital literacy among patients and healthcare professionals.

          Related collections

          Most cited references25

          • Record: found
          • Abstract: found
          • Article: not found

          A Tele-health Follow-up Strategy for Tight Control of Disease Activity in Rheumatoid Arthritis: Results of the Non-inferiority Randomised Controlled Trail (the TeRA study).

          To test the effect of patient-reported outcome (PRO) based tele-health follow-up for tight control of disease activity in patients with rheumatoid arthritis (RA), and the differences between tele-health follow-up performed by rheumatologists or rheumatology nurses.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: found
            Is Open Access

            Providing ‘the bigger picture’: benefits and feasibility of integrating remote monitoring from smartphones into the electronic health record

            Abstract Objectives To establish the acceptability and feasibility of collecting daily patient-generated health data (PGHD) using smartphones and integrating PGHD into the electronic health record, using the example of RA. Methods The Remote Monitoring of RA smartphone app was co-designed with patients, clinicians and researchers using qualitative semi-structured interviews and focus groups, including selection of question sets for symptoms and disease impact. PGHD were integrated into the electronic health record of one hospital and available in graphical form during consultations. Acceptability and feasibility were assessed with 20 RA patients and two clinicians over 3 months. A qualitative evaluation included semi-structured interviews with patients and clinicians before and after using the app, and audio-recordings of consultations to explore impact on the consultation. PGHD completeness was summarized descriptively, and qualitative data were analysed thematically. Results Patients submitted data on a median of 91% days over 3 months. Qualitative analysis generated three themes: RA as an invisible disease; providing the bigger picture of RA; and enabling person-centred consultations. The themes demonstrated that the system helped render patients’ RA more visible by providing the ‘bigger picture’, identifying real-time changes in disease activity and capturing symptoms that would otherwise have been missed. Graphical summaries during consultations enabled a more person-centred approach whereby patients felt better able to participate in consultations and treatment plans. Conclusion Remote Monitoring of RA has uniquely integrated daily PGHD from smartphones into the electronic health record. It has delivered proof-of-concept that such integrated remote monitoring systems are feasible and can transform consultations for clinician and patient benefit.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              2022 EULAR points to consider for remote care in rheumatic and musculoskeletal diseases

              Background Remote care and telehealth have the potential to expand healthcare access, and the COVID-19 pandemic has called for alternative solutions to conventional face-to-face follow-up and monitoring. However, guidance is needed on the integration of telehealth into clinical care of people with rheumatic and musculoskeletal diseases (RMD). Objective To develop EULAR points to consider (PtC) for the development, prioritisation and implementation of telehealth for people with RMD. Methods A multidisciplinary EULAR task force (TF) of 30 members from 14 European countries was established, and the EULAR standardised operating procedures for development of PtC were followed. A systematic literature review was conducted to support the TF in formulating the PtC. The level of agreement among the TF was established by anonymous online voting. Results Four overarching principles and nine PtC were formulated. The use of telehealth should be tailored to patient’s needs and preferences. The healthcare team should have adequate equipment and training and have telecommunication skills. Telehealth can be used in screening for RMD as preassessment in the referral process, for disease monitoring and regulation of medication dosages and in some non-pharmacological interventions. People with RMD should be offered training in using telehealth, and barriers should be resolved whenever possible. The level of agreement to each statement ranged from 8.5 to 9.8/10. Conclusion The PtC have identified areas where telehealth could improve quality of care and increase healthcare access. Knowing about drivers and barriers of telehealth is a prerequisite to successfully establish remote care approaches in rheumatologic clinical practice.
                Bookmark

                Author and article information

                Journal
                RMD Open
                RMD Open
                rmdopen
                rmdopen
                RMD Open
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                2056-5933
                2023
                6 December 2023
                : 9
                : 4
                : e003363
                Affiliations
                [1 ]departmentFaculty of Health Science , University of Bristol , Bristol, UK
                [2 ]departmentInstitute of Digital Medicine , University Hospital Giessen-Marburg, Philipps University , Marburg, Germany
                [3 ]departmentRheumatology , Ringgold_4501Leiden Universitair Medisch Centrum , Leiden, The Netherlands
                [4 ]departmentTranslational and Clinical Research Institute , Newcastle University , Newcastle upon Tyne, UK
                Author notes
                [Correspondence to ] Dr Rachel Knevel; r.knevel@ 123456lumc.nl
                Author information
                http://orcid.org/0000-0001-9695-0657
                http://orcid.org/0000-0002-7494-3023
                Article
                rmdopen-2023-003363
                10.1136/rmdopen-2023-003363
                10711870
                38056918
                ad649847-d5b9-4c3a-9f3c-e68badbf73bc
                © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 04 August 2023
                : 15 November 2023
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100018703, HORIZON EUROPE European Innovation Council;
                Award ID: 101080711
                Categories
                Treatments
                1506
                Viewpoint
                Custom metadata
                unlocked

                therapeutics,arthritis, rheumatoid,autoimmune diseases

                Comments

                Comment on this article