Rheumatology Research Foundation Announces Additional Funds for Telehealth Studies

This week, Rheumatology Network sat down to interview S. Louis Bridges, MD, PhD, to highlight the availability of funds for projects exploring telehealth, as shown in this press release. Bridges is the President of the Rheumatology Research Foundation, as well as Physician-in-Chief and Chair of the Department of Medicine at the Hospital for Special Surgery (HSS), as well as Chief of the Division of Rheumatology at HSS and Weill Cornell College of Medicine. In our interview, we discuss the types of studies that he hopes to see get funded, the current state of telehealth, and what he believes is in store for the future of telemedicine for rheumatologists and patients with rheumatic diseases.

Rheumatology Network: Hi, Dr. Bridges. Thank you for joining me today.

S. Louis Bridges, MD, PhD: My pleasure.

RN: Can you start by giving me a little bit of background on the Rheumatology Research Foundation?

SB: The Rheumatology Research Foundation is a nonprofit started by and integral to the American College of Rheumatology. So, we started as the American College of Rheumatology Research and Education Foundation in 1985. And the name was changed to the Rheumatology Research Foundation. And we are the largest private funder of Rheumatology education and research grants in the country. And so far we've given out, since 1985, about $180 million.

RN: Wow. What is the current state of telehealth for rheumatologists?

SB: So as you know, during the COVID pandemic, many if not all, primatologists were very limited in the number of in-person visits they could conduct. So, a large number of them were shifted to telehealth and a lot were done urgently. And we were on the very steep part of the learning curve as to how best to do telehealth. So, there's a great need for ways to study the impact of telehealth on patient outcomes, how to optimize the way that telehealth works, how to better prepare the patients for a telehealth visit, to manage the problems that are technologies to assess joint swelling, and other manifestations of rheumatic disease. So, although it's going to be part of our practice, I think for many years, and there's a subset of patients that it's very amenable to, there are others that it's not and we need much more information to really make telehealth in rheumatology work in an optimal way.

RN: And what types of studies do you hope to see get funded?

SB: So, the Rheumatology Research Foundation just generated what we call a “notice of special interest.” And so, there's several areas of interest to us in this request for application. So, we really want to, you know, have studies that will help to emerge, help to answer emerging questions about telehealth and rheumatology. So, some of the things that we are interested in are leveraging telehealth to drive health equity and expand access to rheumatology care, particularly in underrepresented minorities and individuals that have trouble with access to care. Try to improve the uptake and satisfaction for both rheumatologist and rheumatology providers, as well as patients helping to drive policies that regulate telehealth to make sure that they are supportive of telehealth for the population that needs it. And we really want things that will drive improvements in patient outcomes, or at least inform how we can improve patient outcomes, using telehealth and tele-rheumatology. Increase access, demonstrate the value of telehealth, deliver healthcare through these mechanisms as efficiently as we can, and to help the providers and the patients to really optimize the success of telehealth in rheumatology.

RN: What challenges do rheumatologists such as yourself face in regard to telemedicine currently?

SB: Well, 1 of the things is that we cannot examine joints as closely as we would in person. So, holding up an iPhone is not as good. So, there's 1 of the things that's of interest is better imaging, such as thermal imaging, to look for signs of inflammation by increased temperature of a joint. So, I think, you know, being physically there will never be replaced even though there are a subset of patients that telehealth will work well for. And then of course, you know, alternatives to injections, such as corticosteroid injections into joints for patients that that can't travel. Those are some of the big shortcomings.

RN: What do you think is in store for the future of telehealth in regard to rheumatologist and just in general?

SB: I think telehealth is here to stay in rheumatology, again, for a certain set of patients. Those that live in very isolated areas that have significant transportation problems. Ideally, patients who are stable and need only a brief check-in with review of medications and ordering of labs throughout toxicity. So, I think that we will not see telehealth go away. If, you know, what we hope is that it will improve better and better care with improved patient outcomes, that it will continue to be reimbursed through insurance plans because it is going to be part of our armamentarium for the foreseeable future. So, I think we will see telehealth in rheumatology expand in certain areas, grow, and improve. And we'll always have the need to see our patients in person at certain times in their disease course. But I think that telehealth is really part of the long term vision of most rheumatologists who do outpatient, because we're mostly an outpatient specialty. I think telehealth and rheumatology is here to stay.

RN: Do you enjoy telehealth?

SB: Not as much as in person, I really don't. I really don't enjoy it as much it feels. As you would expect, you're more than an arm's length away from a person. Seeing the person walk into the room, how they carry themselves, what their disposition seems to be, what the nurses tell us about what's going on with the patients, which we don't always have a chance to do. I think that now, it's good to see my patients rather than not seeing them, but it's not nearly as good as seeing them in person. Even though there are times when the telehealth visit is perfectly acceptable and all that's needed, I still enjoy seeing patients and I missed seeing them in person.

RN: I bet. Is there anything else you'd like to add that we haven't discussed before we wrap up?

SB: No, I don't think so. I think you know, just a small comment that COVID-19 has been terrible. But there's always a little silver lining in everything bad that happens. I think expanding telehealth ultimately will be a good thing. And so COVID, while terrible, has had a little bit of a positive impact on how we deliver health care that might actually be an improvement for some patients. So we have to look at it that way.

RN: That's a good way to look at it. Silver lining. Well, Dr. Bridges, thank you so much for speaking with me today. I really appreciate it.

SB: Thank you very much for having me.