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  11. Telerheumatology Shared-care Model: Leveraging The Expertise Of An Advanced Clinician Practitioner In Arthritis Care (acpac)-trained Extended Role Practitioner In Rural-remote Ontario

Telerheumatology Shared-Care Model: Leveraging the Expertise of an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-Trained Extended Role Practitioner in Rural-Remote Ontario

Amanda Steiman1, Taucha Inrig2, Katie Lundon3

  • 1A. Steiman, MD, MSc, Division of Rheumatology, Sinai Health, and Rebecca Macdonald Centre for Arthritis and Autoimmune Disease, Mount Sinai Hospital and University Health Network.

The Journal of Rheumatology
|June 2, 2024

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View abstract on PubMed

Summary
This summary is machine-generated.

A shared-care telerheumatology model effectively increased access to inflammatory arthritis (IA) care for rural patients. This innovative approach, utilizing an Advanced Clinician Practitioner in Arthritis Care-extended role practitioner (ACPAC-ERP) and a remote rheumatologist, improved care delivery.

Area of Science:

  • Rheumatology
  • Telehealth
  • Health Services Research

Background:

  • A significant shortage of rheumatologists in Canada creates substantial gaps in inflammatory arthritis (IA) care, particularly impacting rural and remote populations.
  • Existing care models have not adequately addressed the increasing demand, necessitating the exploration of alternative strategies to improve access.

Purpose of the Study:

  • To evaluate the impact of a novel shared-care telerheumatology model on IA care delivery in rural-remote Ontario.
  • To assess the effectiveness of integrating an Advanced Clinician Practitioner in Arthritis Care-extended role practitioner (ACPAC-ERP) with an urban-based rheumatologist.

Main Methods:

  • A retrospective chart review was conducted on a telerheumatology clinic established using a hub-and-spoke model.
  • Patients with suspected IA were triaged by an ACPAC-ERP, who performed initial in-person assessments, followed by virtual consultations with a rheumatologist.
Keywords:
allied health personnelcapacity buildingdelivery of healthcare integrationhealth services needs and demand

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Main Results:

  • The study analyzed data from 124 patients, with 98% of visits conducted virtually.
  • Inflammatory arthritis or connective tissue disease was confirmed in 65% of patients.
  • An estimated 493,470 km of patient travel was avoided, demonstrating significant logistical benefits.

Conclusions:

  • The described telerheumatology model, pairing an ACPAC-ERP with a rheumatologist, successfully provided comprehensive virtual rheumatologic care to underserved rural communities.
  • This model demonstrates potential for increasing rheumatology care capacity and addressing access barriers in underserved regions.
healthcare evaluation: outcome and process assessment
medically underserved area