• Divita Jhaveri, Theophilus I Emeto, Faith O Alele, Aleisha Strom, and Helen Benham.
• Rheumatology Department, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
• Intern Med J. 2022 Oct 1; 52 (10): 168516901685-1690.

BackgroundIn Australia there is a shortage of rheumatologists potentially translating to poorer outcomes. A possible solution in this setting is telemedicine (TM).AimsTo examine the utilisation and provider perceptions of TM in rheumatology in Queensland and explore the challenges faced when using TM before and during COVID-19.MethodsA sequential mixed-methods study design was used. Rheumatologists completed a questionnaire on demographics, clinical practice, TM uptake, models of care and clinician perceptions of TM. The qualitative phase utilised purposeful sampling of active users of TM through in-depth semi-structured interviews.ResultsThirty rheumatologists participated, with 76.7% identifying as active TM users. Use of TM was limited prior to COVID-19 with 80.9% examining less than five patients per week. Patient populations served by TM included capital city (53.3%), regional (63.3%) and rural/remote (23.3%). Most rheumatologists prescribed conventional or biological disease modifying agents (90% and 55%) through TM consultations. Barriers to TM use included low confidence in joint assessments, limited distribution of technology, access to administrative and peripheral clinical staff and lack of financial incentives. During the COVID-19 pandemic, a significant expansion of TM via telephone calls occurred and rheumatologists reported low confidence and satisfaction with this model.ConclusionsFamiliarity with TM exists in this rheumatologist cohort; however, its use in routine practice is limited due to multiple barriers. The COVID-19 pandemic highlighted low confidence in telephone calls as a form of TM underlining the need for appropriate TM models of care for rheumatology practice.© 2022 Royal Australasian College of Physicians.

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