title: Telemedicine delivery of patient education in remote Ontario communities: feasibility of an Advanced Clinician Practitioner in Arthritis Care (ACPAC)-led inflammatory arthritis education program.
abstract: OBJECTIVE
  Telemedicine-based approaches to health care service delivery improve access to care. It was recognized that adults with inflammatory arthritis (IA) living in remote areas had limited access to patient education and could benefit from the 1-day Prescription for Education (RxEd) program. The program was delivered by extended role practitioners with advanced training in arthritis care. Normally offered at one urban center, RxEd was adapted for videoconference delivery through two educator development workshops that addressed telemedicine and adult education best practices. This study explores the feasibility of and participant satisfaction with telemedicine delivery of the RxEd program in remote communities.
  
  
  METHODS
  Participants included adults with IA attending the RxEd program at one of six rural sites. They completed post-course program evaluations and follow-up interviews. Educators provided post-course feedback to identify program improvements that were later implemented.
  
  
  RESULTS
  In total, 123 people (36 in-person and 87 remote, across 6 sites) participated, attending one of three RxEd sessions. Remote participants were satisfied with the quality of the video-conference (% agree/strongly agree): could hear the presenter (92.9%) and discussion between sites (82.4%); could see who was speaking at other remote sites (85.7%); could see the slides (95.3%); and interaction between sites adequately facilitated (94.0%). Educator and participant feedback were consistent. Suggested improvements included: use of two screens (speaker and slides); frontal camera angles; equal interaction with remote sites; and slide modifications to improve the readability on screen. Interview data included similar constructive feedback but highlighted the educational and social benefits of the program, which participants noted would have been inaccessible if not offered via telemedicine.
  
  
  CONCLUSIONS
  Study findings confirm the feasibility of delivering the RxEd program to remote communities by using telemedicine. Future research with a focus on the sustainability of this and other models of technology-supported patient education for adults with IA across Ontario is warranted.
authors.affiliation: Learning Institute, The Hospital for Sick Children.
authors.forename: Kelly
authors.initials: K
authors.lastname: Warmington
authors.affiliation: Telemedicine Program.
authors.forename: Carol
authors.initials: C
authors.lastname: Flewelling
authors.affiliation: Musculoskeletal Health & Outcomes Research, St. Michael's Hospital; Institute for Work & Health.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Kennedy
authors.affiliation: Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital.
authors.forename: Rachel
authors.initials: R
authors.lastname: Shupak
authors.affiliation: Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital.
authors.forename: Angelo
authors.initials: A
authors.lastname: Papachristos
authors.affiliation: Martin Family Centre for Arthritis Care & Research, St. Michael's Hospital.
authors.forename: Caroline
authors.initials: C
authors.lastname: Jones
authors.affiliation: Musculoskeletal Health & Outcomes Research, St. Michael's Hospital.
authors.forename: Denise
authors.initials: D
authors.lastname: Linton
authors.affiliation: Musculoskeletal Health & Outcomes Research, St. Michael's Hospital; Institute for Work & Health; Graduate Department of Health Policy, Management and Evaluation; Graduate Department of Rehabilitation Science; Department of Occupational Science and Occupational Therapy, University of Toronto.
authors.forename: Dorcas E
authors.initials: DE
authors.lastname: Beaton
authors.affiliation: The Arthritis Society (Ontario Division), Toronto, ON, Canada.
authors.forename: Sydney
authors.initials: S
authors.lastname: Lineker
keywords: feasibility; patient satisfaction; rheumatoid arthritis; tele-education; telehealth