Digital Health in Rheumatology: Opportunities and Challenges According to Patients and Professionals (Preprint)

This is the authors' abstract. We don't add key points for this paper.

BACKGROUND Telemedicine is emerging as a powerful tool that can improve disease management in rheumatology. However, it has not been sufficiently implemented in daily clinical practice. OBJECTIVE To assess the needs and preferences of patients and healthcare professionals regarding the implementation of digital health solutions in rheumatology. METHODS Two digital surveys targeted patients with immune-mediated inflammatory diseases and health professionals, respectively. The surveys featured questions rated on a scale of 1 to 10 (1 indicating the lowest level of agreement and 10 the highest) addressing 8 domains for patients (contacting rheumatologist, regular app usage, disease-related apps, telematic visits, telemonitoring experience, tools used, digital evaluation, and app features) and 7 domains for health professionals (usefulness of telemonitoring, training in digital health, telemonitoring experience, tools used, potential monitorable aspects, impediments to telemonitoring, tools available). Patient recruitment was facilitated by patient associations. RESULTS A total of 135 patients (86.7% women; mean age, 48.6±12.5 years) and 53 healthcare professionals (88.7% rheumatologists and 9.4% nurses) participated in the study. Among patients, 24.7% experienced difficulties contacting their rheumatologist during relapses of their disease, and few reported using apps related to their condition, with a mean score of 3.3±2.6. More than half of the patients reported having limited experience with telemedicine; the ability to improve communication with healthcare professionals ranked highest (8.1 ± 2.8). Among the healthcare professionals, 75% considered that telemedicine could be beneficial in rheumatology, although only 26.9% reported having received specific training, with a score of ≥7 or above, and 53.9% indicated minimal use of telemonitoring tools, with a score ≤2. The most widely agreed-upon aspect for monitoring between professionals was treatment adherence (7.56±2.24), and the main barriers they perceived for the implementation of telemedicine were the lack of integration between devices and the electronic health records (EHRs) (8.53±2.11) and the burden of care (7.66±2.78). In contrast, lack of interest in the field was considered the least significant barrier (5.08±2.62). CONCLUSIONS Telemonitoring could offer advantages for both patients and healthcare professionals in certain clinical situations, yet significant unmet needs remain. Areas to improve include app design, enhanced training for both patients and professionals, and ensuring seamless integration with EHR systems to support real-world implementation.