Nguyen-Oghalai Tracy U, Hunter Kathy, Lyon Michael
From the University of Southern California, Los Angeles, and Palo Alto Veterans Administration Hospital, Palo Alto, California.
South Med J. 2018 Jun;111(6):359-362. doi: 10.14423/SMJ.0000000000000811.
We sought to characterize the correlation between diagnoses made during telerheumatology and face-to-face visits and to document patients' satisfaction with telerheumatology visits.
This quality assurance study of the use of telerheumatology evaluated new patients referred to a Veterans Affairs rheumatology clinic. Patients were seen at a community clinic by a nurse practitioner with a rheumatologist participating in the encounter via telelink. All of the patients had a second face-to-face visit with the same rheumatologist. Diagnoses made during telerheumatology and face-to-face visits were compared. Patients' satisfaction with telerheumatology was ascertained.
Thirty-eight patients were included in the study. Initially, 23 were diagnosed as having an inflammatory or rheumatic condition; 15 were subsequently confirmed at the face-to-face visits. All of the patients with inflammatory, rheumatic conditions were identified at the telerheumatology visits. The overall correlation was 79% between the telerheumatology and face-to-face visits. Among patients with inflammatory, rheumatic conditions, 66% preferred a face-to-face visit compared with 41% among those without such conditions (not significant). Immediately after the telerheumatology visit, all of the patients gave a 10 out of 10 rating for satisfaction. During the subsequent telephone survey, 30 remained highly satisfied with the telemedicine encounter (10 out of 10 rating).
Telerheumatology at the Palo Alto Veterans Affairs was well received by patients; provided an accurate diagnosis of noninflammatory, nonrheumatic conditions; and may be appropriate for screening and prioritizing patients for in-person rheumatology clinics.
我们试图描述远程风湿病诊疗与面对面诊疗之间诊断结果的相关性，并记录患者对远程风湿病诊疗的满意度。
这项关于远程风湿病诊疗使用情况的质量保证研究评估了被转诊至退伍军人事务部风湿病诊所的新患者。患者在社区诊所由一名执业护士进行诊疗，同时一名风湿病专家通过远程连接参与会诊。所有患者均与同一名风湿病专家进行了第二次面对面诊疗。比较了远程风湿病诊疗和面对面诊疗期间做出的诊断。确定了患者对远程风湿病诊疗的满意度。
38名患者纳入研究。最初，23名患者被诊断患有炎症性或风湿性疾病；其中15名在面对面诊疗时得到了确诊。所有患有炎症性、风湿性疾病的患者在远程风湿病诊疗时均被识别出来。远程风湿病诊疗与面对面诊疗的总体相关性为79%。在患有炎症性、风湿性疾病的患者中，66%更倾向于面对面诊疗，而在无此类疾病的患者中这一比例为41%（差异无统计学意义）。在远程风湿病诊疗结束后，所有患者对满意度的评分均为满分10分。在随后的电话调查中，30名患者对远程医疗会诊仍高度满意（评分10分）。
帕洛阿尔托退伍军人事务部的远程风湿病诊疗受到患者的好评；能够准确诊断非炎症性、非风湿性疾病；可能适用于对面对面风湿病诊所的患者进行筛查和确定优先次序。
