Telehealth in rheumatology: the 2021 Arab League of Rheumatology Best Practice Guidelines

Nelly Ziade 1 2, Ihsane Hmamouchi 3 4, Lina El Kibbi 5, Melissa Daou 6, Nizar Abdulateef 7, Fatemah Abutiban 8, Bassel Elzorkany 9, Chafia Dahou-Makhloufi 10, Wafa Hamdi 11, Samar Al Emadi 12, Hussein Halabi 13, Khalid A Alnaqbi 14 15, Sima Abu Al Saoud 16, Soad Hashad 17 18, Radouane Niamane 19, Manal El Rakawi 20, Layla Kazkaz 21, Sahar Saad 22 23, Mervat Eissa 9, Ilanca Fraser 24, Basel Masri 25

Affiliations

01 March 2022

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doi: 10.1007/s00296-021-05078-w

Abstract

To develop Best Practice Guidelines (BPG) for the use of Telehealth in Rheumatology in the Arab region, to identify the main barriers and facilitators of telehealth, and to provide rheumatologists with a practical toolkit for the implementation of telehealth. Guidelines were drafted by a core steering committee from the Arab League of Associations for Rheumatology (ArLAR) after performing a literature search. A multidisciplinary task force (TF), including 18 rheumatologists, 2 patients, and 2 regulators from 15 Arab countries, assessed the BPG using 3 rounds of anonymous online voting by modified Delphi process. The statements were included in the final BPG without further voting if ≥ 80% of TF members indicated high agreement. The voting on barriers and facilitators was performed through one voting round. The toolkit was developed based on available literature and discussions during the Delphi rounds. Four General Principles and twelve Statements were formulated. A teleconsultation was specifically defined for the purpose of these guidelines. The concept of choice in telehealth was highlighted, emphasizing patient confidentiality, medical information security, rheumatologist's clinical judgment, and local jurisdictional regulations. The top barrier for telehealth was the concern about the quality of care. The toolkit emphasized technical aspects of teleconsultation and proposed a triage system. The ArLAR BPG provide rheumatologists with a series of strategies about the most reliable, productive, and rational approaches to apply telehealth.

Keywords: Best practice; Guidelines; Rheumatology; Telehealth; Telemedicine.

Conflict of interest statement

One of the co-authors is a medical writer from the company Value in Research, which received funding from Pfizer to organize the Delphi process and medical writing. All the other authors didn’t receive any financial support for this study.

Figures

Fig. 1 Study flowchart

Fig. 1 Study flowchart

Fig. 2 Triage system for a teleconsultation in rheumatology. *Provided that the patient accepts teleconsultation

Fig. 2 Triage system for a teleconsultation in rheumatology. *Provided that the patient accepts teleconsultation

Fig. 3 Toolkit for the implementation of telehealth in the rheumatology clinic. *Technical checklist: Check if your device and browser support the telehealth platform. Check if your internet is stable. Check sound and webcam on your device. Have a backup plan if the connection fails. Take time to familiarize yourself with the telehealth platform and its functions. Ensure all your devices are charged and have the chargers handy in case your battery drain; Close other apps/programs before the visit to improve speed/connectivity. **Environment checklist: Set up your workspace so that you are front-lit, the camera view covers approximately your head and shoulders, and the camera is at eye height. Make sure the background is not distracting. You might consider using a virtual background with your hospital logo or design. Dress professionally

Fig. 3 Toolkit for the implementation of telehealth in the rheumatology clinic. *Technical checklist: Check if your device and browser support the telehealth platform. Check if your internet is stable. Check sound and webcam on your device. Have a backup plan if the connection fails. Take time to familiarize yourself with the telehealth platform and its functions. Ensure all your devices are charged and have the chargers handy in case your battery drain; Close other apps/programs before the visit to improve speed/connectivity. **Environment checklist: Set up your workspace so that you are front-lit, the camera view covers approximately your head and shoulders, and the camera is at eye height. Make sure the background is not distracting. You might consider using a virtual background with your hospital logo or design. Dress professionally

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KMEL References

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