Effectiveness of Tele-Rheumatology for Delivering High Quality Rheumatology Care During the COVID-19 Crisis

The coronavirus disease crisis (COVID-19) has impacted nearly every facet of the U.S. healthcare system and dramatically altered healthcare delivery in the U.S. Since March 2020, remotely delivered care (e.g., tele-rheumatology) has seen exponential growth as providers and healthcare systems have worked to deliver care, especially in non-procedural specialties like rheumatology, which manages rheumatic and musculoskeletal diseases (RMDs). RMDs are one of the most common reasons to seek outpatient care, and patients living with RMD are distinctly at risk for COVID-19 due to multimorbidity burden. The standard of care for many RMDs (e.g., rheumatoid arthritis, lupus) is to use immunosuppressive drugs, which increase the risk for infections and require close monitoring for side effects. Little is known about whether higher risk and socially vulnerable groups of people with RMD have a greater burden of inadequate healthcare during the COVID-19 era. While tele-rheumatology may have an important role to play for delivering healthcare in this population, there exists a clear knowledge gap about the comparative effectiveness of tele-rheumatology versus in-person visits (i.e., usual care) especially in patients on immunosuppressive drugs and socially vulnerable persons. Thus, it is critical to rapidly and rigorously assess patients' acceptance, barriers, and satisfaction with telerheumatology. Given the protracted nature of the pandemic, this proposal advances the mission of the Rheumatology Research Foundation by improving our knowledge and understanding of urgent clinical and policy needs to provide safe, efficacious, and equitable care to diverse patients with RMDs during and beyond the COVID-19 pandemic.