Telehealth-Delivered Healthcare to Improve Care (THRIVE) in Community-Practice Rheumatology

In 2020, the advent of the COVID-19 pandemic resulted in a massive increase in the use of home-based telehealth to provide clinical care in community rheumatology, yet there are scant research studies that a) describe how to best implement telehealth; b) evaluate rheumatology patient satisfaction with telehealth; and c) enumerate the most relevant processes and outcomes and the associated factors that may mediate high quality telehealth care. This project will convene a set of stakeholders including community-practice clinicians, clinical researchers, telehealth experts, patients, and patient advocates to re-design community-based rheumatology telehealth care. Informed by a systematic literature review, we will codify the best practices in telehealth rheumatology, adapt those to the practice of rheumatology, and then implement those best practices to condition-specific care pathways in use by a large, 250+ provider community rheumatology network. We will measure rheumatology patient satisfaction with telehealth to inform these best practices with quantitative data, especially identifying the patient-, provider-, and practice-level factors associated with patients being satisfied (or not) with telehealth services. We will also create video-guided patient education to standardize elements of patient self-examination with a focus on RA and develop companion provider-facing training on how to conduct a standardized, structured exam over a telehealth video interface. This work will be supported by the rigor of a validation study that compares telehealth exam findings to in-person exam findings. We will incorporate and disseminate these tools not only to the large rheumatology community provider network participating in this project but also to community rheumatologists everywhere through a variety of distribution channels. Our work encompasses several innovative research methods including community participatory research, patient involvement in research development, and use of both qualitative and quantitative methods to achieve our goals. Ultimately, these aims will solidify high quality telehealth as an integral part of rheumatology care and preserve access to telehealth services for patients and providers in the future. This project is a collaboration with University of Alabama at Birmingham, Global Healthy Living Foundation, and Bendcare, LLC