What to Know About Telehealth for Arthritis

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Telehealth existed before the COVID-19 pandemic, but it only recently has changed the dynamic of the doctor-patient relationship. Concern about the exposure to the coronavirus made people hesitant to make in-person medical visits. As a result, doctors are navigating new ways to communicate with and provide care to their patients.

Rheumatology is unique when it comes to providing quality patient care. Your rheumatologist will want to examine your joints and assess your range of motion, especially as it pertains to your quality of life. With telemedicine, their job becomes harder.

Fortunately, doctors and their patients have learned to adapt and have found creative ways to communicate and overcome limitations that telehealth might pose. Learn more about telehealth for arthritis, its benefits and challenges, preparing for your visit, what might happen during your visit, and more.

Couple attends telehealth visit from home

SDI Productions / Getty Images

When to Use Telehealth for Arthritis

When you live with an arthritis condition—whether it is osteoarthritis (OA) or inflammatory arthritis (i.e., rheumatoid arthritis and psoriatic arthritis)—it is important to stay in touch with your doctor and on top of your treatment plan.

A telehealth visit, which involves seeing your healthcare professional using a tablet, computer, smartphone, or another mobile device, is a good alternative during the COVID-19 pandemic.

Remote access to your doctor can increase your participation in your care. This is especially important if you are medically vulnerable to COVID-19.

For your arthritis care, telemedicine can be helpful:

  • When you are feeling unwell or experiencing pain or high disease activity from inflammatory arthritis
  • For screening to determine if they need to see you in person: your doctor can see swollen joints over the video call and decide
  • For follow-up to an in-person visit

During your telehealth visit, your doctor can find out how you are feeling by asking about symptoms and doing a visual exam that can include a range of motion and balance. 

You May Need to Be Seen In Person

Telemedicine might not work for every situation. If you have other symptoms related to arthritis, such as pulmonary symptoms or even eye inflammation, your doctor may want to assess you in person.

You might also need an in-person appointment for an initial visit or if your disease isn’t responding to treatments. 

You may need to go into your doctor’s office or a laboratory for routine blood work. Infusion treatments for different types of inflammatory arthritis are typically done at your doctor’s office or an infusion center and require an in-person visit.

Benefits and Challenges

Most medical providers agree that, despite some limitations, telehealth can be an effective way to give people access to their healthcare, for a medication review, and for reviewing and requesting lab work. Most states allow physicians to meet with a new patient via telehealth.

However, the American Medical Association believes that a valid patient-doctor relationship, which in some situations means a face-to-face interaction, must be established before providing care via telehealth. But these are unusual times, and telehealth is the only option for many people, especially those most vulnerable to COVID-19.

A study reported in 2018 found that telemedicine for knee osteoarthritis was convenient and effective, especially in remote areas. While it is not a complete replacement for in-person care, it is a good alternative, especially during the COVID-19 pandemic.

New research about telehealth in rheumatology is positive. It shows that it is most effective for people who are already diagnosed and living with an arthritis condition.

One study reported in 2020 in the journal Arthritis Care & Research found no difference in the quality of care or treatment outcomes in people who received in-person care only versus a mix of in-person and online care.

Additionally, most people are content with the care they are receiving virtually from their rheumatologists. A study reported in 2020 in Clinical Rheumatology found that 71% of respondents were satisfied with their telehealthcare.

The American College of Rheumatology “supports the role of telemedicine as a tool with the potential to increase access and improve care for patients with rheumatic diseases.” But they add that it should not replace essential in-person assessments.

Telehealth has its benefits and challenges. Benefits might include minimizing the spread of illness, saving time, convenience, and reducing canceled and no-show appointments. Challenges include technology setbacks, age, generational differences, and limits on your doctor’s ability to assess you.

Reduces the Spread of Illness

A telehealth appointment can reduce the potential of picking up new germs or spreading illness to other people. This has become especially important during the COVID-19 pandemic.

While medical offices and hospitals have instituted effective procedures to prevent the spread of illness during the pandemic, some risk remains. It makes sense to stay home and take advantage of virtual visits with your medical team.

People who are not sick might be hesitant to visit their doctors for fear of contracting the coronavirus. And if they have a type of arthritis that causes a compromised immune system, they need to limit their exposure.

Time Savings

An in-person appointment requires more time than a virtual visit. A study conducted by Harvard Medical School looked at how much time was spent on medical visits. They found a typical visit consumes an estimated 121 minutes for a patient, including travel time, time in the waiting room, and only 20 minutes seeing their doctor.

A virtual visit cuts this time significantly because there is no travel, plus you can fill out forms online before your appointment. Without all that waiting and traveling, you make better use of your time.

Convenience

Telehealth is convenient. As mentioned, it doesn’t require travel, and you can connect from anywhere. Both mean telehealth visits don’t take up too much of your day, and they reduce the time you would have to take off from work or school to see your doctor.

Telehealth can also reduce the stress of finding transportation or childcare. It is additionally helpful to people who are not feeling well or who have mobility challenges.

Fewer Canceled or No-Show Appointments

Because telehealth appointments are much more convenient, they don’t get canceled as often. People are more likely to show up for a telehealth visit. A virtual visit means fewer obstacles that cause you to cancel, such as transportation issues, illness, a job, or family factors.

Technology Setbacks

Telehealth requires access to the internet. While parts of your appointment can occur by phone, your doctor will need to see you to assess you. Research from the Pew Research Center finds up to 10% of Americans do not use the internet.

Telehealth visits also require a good online connection, and not everyone has that—either because of where they live or because of cost. Losing connection means the visit stops and might need to be lengthened or rescheduled.

In addition to a good internet connection, telehealth requires devices that support these services. Many people do not have access to these technologies because, for instance, they are older or can’t afford them. If they don’t have the right devices, then they don’t have access to telehealth services.

Age and Generation Restrictions

Technology is something younger people are used to having and using. With their busy schedules, they value the convenience of having digital options. However, older generations are not as open to using telehealth for their medical needs. They might also struggle with technology because they don’t use technology as frequently.

A study reported in December 2020 out of Japan focused on the willingness to use telehealth by people with knee OA. They looked at factors such as age, accessibility to a smartphone, hospital visiting time, and severity of knee OA.

In this study, less than 37% of the study participants said they were willing to use telehealth. Compared to those who were willing to use telehealth, those unwilling to use it were on average older and less likely to possess a smartphone.

Assessment Limitations

There is only so much your doctor can assess through a telehealth visit. That usually involves what they can see and what you tell them. Your doctor may also need tools to assess your condition, although they can ask you to come in for an in-person follow-up, if necessary.

How to Prepare for a Telehealth Visit for Arthritis

The first thing you want to do to prepare for your arthritis telehealth visit is to ensure you have access to the necessary technology. If all you need is audio, then your phone is enough. However, if the visit requires an examination by video, you will need a smartphone, tablet, or computer.

The device will need to be equipped with a microphone, webcam, and the teleconference software your doctor’s office uses. You will also need a good internet connection.

For a video appointment, your doctor’s office will provide you with a link to access an online patient portal or videoconference application (app). Your doctor’s office might use apps that include FaceTime, Zoom, Google Hangouts, Skype, or an application specifically designed for their affiliated hospital.

Before you log in to your appointment, you want to make sure you are prepared in other ways. This might include making sure your insurance company covers the visit.

Will Insurance Cover Telehealth for Arthritis?

Insurance companies might differ in whether they cover telehealth appointments and the rates they charge. Some may cover video visits but not telephone visits, but most insurance companies are making exceptions during the pandemic.

You can find out about coverage information by contacting the phone number on the back of your insurance card. Private insurers, including Aetna, Blue Cross Blue Shield, and United Healthcare, are waiving co-pays for telehealth during the pandemic.

The Centers for Medicare and Medicaid have issued temporary measures to make it easier for people enrolled in Medicare, Medicaid, and the Children’s Health Insurance Program (CHIP) to utilize telehealth during the pandemic. Your state may have its own rules as well.

For people who use Medicare, some healthcare facilities are waiving co-pays for telehealth or reducing the cost of visits.

Try to test your technology in advance of your appointment. Ensure your camera and microphone are enabled. Your doctor’s office staff might be able to walk you through the telehealth visit platform in advance.

After you have confirmed your setup, attend your virtual appointment in a quiet, well-lit area.

Be prepared before meeting with your doctor. Keep a pen and paper handy to take notes. Write down any questions you might have in advance so you can make the most of your time with your doctor.

You should also have a list that includes all the medications and supplements you take, any new symptoms, and your insurance information.

What Happens During the Visit

You can expect your telehealth visit to be similar to an in-person visit with your doctor. Your doctor will ask you about your current symptoms and if any are new, how you are feeling overall, and if you feel your current medications are helping.

They might also ask you to show them any areas of your body where you are experiencing joint swelling, such as a swollen knee; or if your inflammatory arthritis affects your skin, they may want to see rashes on your skin.

Depending on your symptoms, medications, and what you have told your doctor, they might schedule an in-person follow-up visit. You might also be able to use your doctor’s patient portal to ask questions after your appointment.

A Word From Verywell

Telehealth visits might be here to stay. However, the form they will take and their role after the pandemic is currently unknown.

For the time being, telehealth has been a helpful tool for people who are having anxiety about leaving their homes during the pandemic and for those with chronic medical conditions for whom infections might be dangerous.

Telehealth can mean the difference between receiving prompt treatment for an ongoing or new medical condition and forgoing health care.

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Article Sources
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