title: A comparative study on the utility of telehealth in the provision of rheumatology services to rural and northern communities.
abstract: BACKGROUND
  There is a critical shortage of specialty rheumatology services in Canada. The impact is felt more in rural and northern regions than on urban areas of the country. In response to the need, this study was conducted to compare the satisfaction of referring physicians with rheumatology services through conventional visiting specialty clinics; email consults and regularly scheduled videoconference.
  
  
  METHODS
  Three rural communities of similar size and availability of physician services were assigned to one of the following means of providing outreach rheumatology services: visiting rheumatologist clinics, email access to rheumatologist and scheduled videoconference consults. A case based pre/post test, and post satisfaction questionnaire were administered to the primary care physicians in these communities. Patient outcomes, and physician ability and confidence in managing specific arthritis problems, were measured.
  
  
  RESULTS
  Physicians responded positively to all methods of rheumatology service provision. The videoconference group were the most positive. The reasons were: immediate feedback to referring physician and patient, effective case based learning and transfer of knowledge, and improved accessibility.
  
  
  CONCLUSIONS
  Videoconference is preferred to visiting clinics and email as a method for rheumatology services to rural/northern communities. It is cost effective and there is knowledge transfer between the rheumatologist and the referring physicians.
authors.affiliation: Memorial University of Newfoundland, Labrador Health Center, Canada. mjong@hvgb.net
authors.forename: Michael
authors.initials: M
authors.lastname: Jong
authors.forename: Majed
authors.initials: M
authors.lastname: Kraishi
mesh_terms: D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000628:therapy; D001291:Attitude of Health Personnel; D019538:Health Care Surveys; D006801:Humans; D008507:Medically Underserved Area; D020380:Needs Assessment; D009523:Newfoundland and Labrador; D017060:Patient Satisfaction; D010818:Practice Patterns, Physicians'; D011365:Professional Practice Location; D019114:Remote Consultation / Q000592:standards / Q000639:trends; D012219:Rheumatology / Q000592:standards* / Q000639:trends; D012424:Rural Population; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000706:statistics & numerical data*; D049269:Videoconferencing