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Researchers cut arthritis consultation costs with mobile app

A China-based study shows U.S. hospitals how they can reduce care costs and create new revenue by treating patients in other cities.

Jeff Lagasse, Associate Editor

Researchers at multiple institutions in China collaborated to develop the Smart System of Disease Management, a series of applications based on clinical data working in conjunction with a system that includes online consultation through a mobile app to improve care management among rheumatic disease patients. 

The statistics make such an approach attractive: 100 million people in China suffer from the rheumatic disease, yet the country boasts only 5,000 rheumatologists, most of whom are concentrated in larger cities. Some rheumatologists in the country see 60 to 100 patients per day, spending about three minutes with each, on average. 

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While the numbers of patients with some sort of rheumatic disease in the United States aren't as drastic as they are in China, the findings have implications for American medicine, which has employed the use of technology and telemedicine services to a larger degree in recent years -- especially in rural areas, where access to healthcare services is often an issue. 

Health leaders cite technology's ability to not only reach more people but make clinical workflow more efficient and save money on treatment costs. As such, being able to spend more time with patients is a dream for many American clinicians -- and has the potential to not only heighten the quality of care but mitigate their level of burnout.

Previous research indicates that rheumatoid arthritis patients trained to use SSDM were able to perform self-management afterward, including disease activity scoring of 28 joints and health assessment questionnaire evaluations and medication and lab test data entry. The aim of the study was to evaluate the economic feasibility and medical benefits of using SSDM for online consultation with a rheumatologist.

From February 2015 to June 2017, 403 rheumatologists supplied 4,002 patients with RA, lupus, ankylosing spondylitis, gout, osteoarthritis, Sjögren's syndrome and other rheumatic diseases with 293 free and 3,709 paid consultations. 

The patient's tech toolbox includes self-assessment, medication management, adverse events management and laboratory records. Patients enter the data and then submit it to their authorized doctor. Rheumatologists then may accept the request from their follow-up patients and consult via text or voice through SSDM.

Researchers surveyed the patients to determine their satisfaction with SSDM, and found that 66.35 percent reported their experience with online consultation as "very satisfying."

Within the program, 35.3 percent of patients who received online consultations lived in a different city from the rheumatologists. And the researchers said that had those people sought care at a hospital instead, the total cost would have been 6.61 times higher than the virtual visit.

The findings, presented this week at the 2017 ACR/ARHP Annual Meeting in San Diego, highlight opportunities for both reducing expenses and opening new revenue opportunities for doctors and hospitals. 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com

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