Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study

Muehlensiepen, Felix; Knitza, Johannes; Marquardt, Wenke; May, Susann; Krusche, Martin; Hueber, Axel; Schwarz, Julian; Vuillerme, Nicolas; Heinze, Martin; Welcker, Martin

doi:10.3390/ijerph182413127

Open AccessArticle

Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study

by

Felix Muehlensiepen

^1,2,3,4,*

,

Johannes Knitza

^4,5,6

,

Wenke Marquardt

¹,

Susann May

²,

Martin Krusche

⁷,

Axel Hueber

⁸

,

Julian Schwarz

⁹,

Nicolas Vuillerme

^4,10,11

,

Martin Heinze

^2,3,9 and

Martin Welcker

¹²

¹

KV Consult-und Managementgesellschaft mbH, 14469 Potsdam, Germany

²

Center for Health Services Research, Brandenburg Medical School Theodor Fontane, 15562 Rüdersdorf bei Berlin, Germany

³

Faculty of Health Sciences Brandenburg, Brandenburg Medical School Theodor Fontane, 16816 Neuruppin, Germany

⁴

AGEIS, Université Grenoble Alpes, 38000 Grenoble, France

⁵

Department of Internal Medicine 3-Rheumatology and Immunology, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany

⁶

Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany

⁷

Department of Internal Medicine III, University Medical Center Hamburg-Eppendorf, 20251 Hamburg, Germany

⁸

Division of Rheumatology, Klinikum Nürnberg, Paracelsus Medical University, 90419 Nürnberg, Germany

⁹

Department of Psychiatry and Psychotherapy, Brandenburg Medical School Theodor Fontane, Immanuel Klinik Rüdersdorf, 15562 Rüdersdorf, Germany

¹⁰

Institut Universitaire de France, 75006 Paris, France

¹¹

LabCom Telecom4Health, Orange Labs & Université Grenoble Alpes, CNRS, Inria, Grenoble INP-UGA, 38400 Grenoble, France

¹²

Medizinisches Versorgungszentrum für Rheumatologie Dr. M. Welcker GmbH, 82152 Planegg, Germany

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Author to whom correspondence should be addressed.

Int. J. Environ. Res. Public Health 2021, 18(24), 13127; https://doi.org/10.3390/ijerph182413127

Submission received: 13 October 2021 / Revised: 7 December 2021 / Accepted: 9 December 2021 / Published: 13 December 2021

(This article belongs to the Special Issue Improving Health Management and Well-Being for Young and Older Adults with eHealth and mHealth)

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Abstract

Despite all its promises, telemedicine is still not widely implemented in the care of rheumatic and musculoskeletal diseases (RMDs). The aim of this study is to investigate opportunities, barriers, acceptance, and preferences concerning telemedicine among RMD patients and professional stakeholders. From November 2017 to December 2019, a participatory, mixed-methods study was conducted, consisting of (1) expert interviews (n = 27) with RMD patients and professional stakeholders, (2) a national paper-based patient survey (n = 766), and (3) focus groups (n = 2) with patient representatives and rheumatologists. The qualitative findings indicate that patients equate personal contact with physical face-to-face contact, which could be reduced by implementing telemedicine, thus negatively influencing the patient–doctor relationship. Correspondingly “no personal contact with the doctor” is the main reason (64%) why 38% of the surveyed patients refuse to try telemedicine. Professional stakeholders expect telemedicine to contribute to the effective allocation of scarce resources in rheumatology care. The main barriers reported by stakeholders were the scarcity of time resources in RMD care, the absence of physical examinations, and organizational challenges associated with the implementation of telemedicine in RMD care. While the exact integration of telemedicine into routine care has yet to be found, the consequences on the patient-physician relationship must be permanently considered.

Keywords: chronic disease; rheumatology; telemedicine; eHealth; mHealth; patient perspective; mixed methods; qualitative research; survey

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MDPI and ACS Style

Muehlensiepen, F.; Knitza, J.; Marquardt, W.; May, S.; Krusche, M.; Hueber, A.; Schwarz, J.; Vuillerme, N.; Heinze, M.; Welcker, M. Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study. Int. J. Environ. Res. Public Health 2021, 18, 13127. https://doi.org/10.3390/ijerph182413127

AMA Style

Muehlensiepen F, Knitza J, Marquardt W, May S, Krusche M, Hueber A, Schwarz J, Vuillerme N, Heinze M, Welcker M. Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study. International Journal of Environmental Research and Public Health. 2021; 18(24):13127. https://doi.org/10.3390/ijerph182413127

Chicago/Turabian Style

Muehlensiepen, Felix, Johannes Knitza, Wenke Marquardt, Susann May, Martin Krusche, Axel Hueber, Julian Schwarz, Nicolas Vuillerme, Martin Heinze, and Martin Welcker. 2021. "Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study" International Journal of Environmental Research and Public Health 18, no. 24: 13127. https://doi.org/10.3390/ijerph182413127

APA Style

Muehlensiepen, F., Knitza, J., Marquardt, W., May, S., Krusche, M., Hueber, A., Schwarz, J., Vuillerme, N., Heinze, M., & Welcker, M. (2021). Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study. International Journal of Environmental Research and Public Health, 18(24), 13127. https://doi.org/10.3390/ijerph182413127

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Opportunities and Barriers of Telemedicine in Rheumatology: A Participatory, Mixed-Methods Study

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