One month into the crisis caused by COVID-19 (coronavirus disease 2019; the disease caused by SARS-CoV-2) in the United States, rheumatologists began to feel the effects of our hastily constructed temporary response plans. While we may not have been staffing the front lines with our colleagues in emergency medicine and critical care, our patients were uniquely vulnerable to infection and continued to require care. Managing their illnesses remained no less important then than it ever was. Necessity forced us to learn important lessons about delivering this care in safer, more efficient ways. While some of these adaptations will revert to “business as usual,” others may change the way we communicate with patients and colleagues long after this crisis has passed.
In our own clinic, the importance of social distancing catalyzed a transition to telemedicine. Healthcare has typically been excluded from stay-at-home orders, so patients can still come into the clinic, but should they? Many of us practice in large medical complexes. Reducing traffic in these locations makes social and medical sense. Even for rheumatologists with independent offices, waiting rooms are a worrisome potential locus for virus transmission. Most importantly, physicians and medical staff have close personal contact with dozens of patients per day, many of whom could be asymptomatic carriers. The rationale for moving to telemedicine was strong.
Telemedicine is not new to rheumatology. Publications on telemedicine approaches go back 20 years, though the major focus has typically been on the use of these tools to deliver specialty care to rural areas1,2. Despite this, adoption has been slow, and in many places, nonexistent. Many factors have …
Address correspondence to Dr. E.M. Ruderman, Northwestern University Feinberg School of Medicine, Division of Rheumatology, 675 North St. Clair 14-100, Chicago, Illinois 60611, USA. E-mail: e-ruderman{at}northwestern.edu
