Rheumatology, eHealth, telemonitoring
Rheumatic care is usually delivered during regular hospital appointments. The frequency of these contacts is dictated by guidelines rather than the needs of patients. Patients will often achieve low disease activity within one year of intensive treatment, but will retain their regular appointments. The Dutch Society for Rheumatology founded an eHealth working group to study whether this care can be conducted outside hospitals, i.e. at home, supported by eHealth and telemonitoring. To this end the taskforce drew up a framework in which patients in low disease activity or remission no longer need to frequent the participating hospitals, but are periodically questioned with smartphone applications. Because many patients have low literacy and low digital skills, and because patients dislike filling out questionnaires when they are doing well, these assessments will be as generic as possible using a smiley matrix. Only when patients report having health issues does further questioning occur, which may subsequently lead to a teleconsultation, face-to-face appointment or eHealth intervention. The digital infrastructure will utilize existing eHealth applications as much as possible. The present grant application entails setting up the infrastructure, a subsequent study on the cost-effectiveness of this strategy and finally an open extension follow-up of implementation.
ZonMw, NVR, MST, Reade, MUMC