TY - JOUR
T1 - Addressing Competency in Rheumatology Telehealth Care Delivery
AU - for the American College of Rheumatology Committee on Training and Workforce
AU - Zickuhr, Lisa
AU - Albert, Daniel A.
AU - Herndon, Connie
AU - Imundo, Lisa F.
AU - Lopker, Michael J.
AU - Marston, Bethany
AU - Mian, Nabeela
AU - O'Rourke, Kenneth
AU - Torralba, Karina D.
AU - Westrich-Robertson, Tiffany
AU - Venuturupalli, R. Swamy
AU - Kolfenbach, Jason
AU - Bolster, Marcy B.
N1 - Funding Information:
The ACR COTW invited 12 members to participate in the rheumatology TCs working group (LZ, DAA, LFI, MJL, BM, NM, KO, KDT, TW-R, RSV, JK, and MBB), all of whom were experienced providers or consumers of rheumatology telehealth. The working group included clinicians, educators, a fellow-in-training, and a patient from diverse geographic locations and practice settings (Table 1). The composition of the working group enhanced the variety of perspectives incorporated into the rheumatology TCs, and patient participation reinforced the mission to define skills essential for delivering patient-centered telehealth care to those with rheumatic diseases. Values are the number (%) unless indicated otherwise. Two members are board certified in pediatric and adult rheumatology. The working group implemented a collaborative process commonly used in educational scholarship to fulfill its primary aim (10,11). From June 2021 through March 2022, the working group conducted 5 meetings to discuss key issues and draft the rheumatology TCs. As a first step, the working group defined “telehealth” in the context of this project as encompassing the use of real-time video and audio-only visits, referencing these terms interchangeably. While telehealth care includes a broader range of modalities such as asynchronous care, the working group focused on the 2 modalities of real-time video and audio-only visits because of their prevalence in fellowship training and patient care (12). Next, the working group defined the skills required to provide telehealth care to patients with rheumatic disease, described the unique abilities of recent rheumatology fellowship graduates, and developed competencies to encompass the nuances in rheumatology telehealth care. The working group followed the 6 domains (Figure 1) and the continuum of clinician experience outlined in the AAMC TCs (see Supplementary Table 1, available on the Arthritis Care & Research website at http://onlinelibrary.wiley.com/doi/10.1002/acr.25023), expanding the competencies when needed (Table 2). When the working group identified novel skills in the practice of rheumatology telehealth, additional competencies were crafted for both the recent fellowship graduate and the experienced clinician. The items in this table include the rheumatology-specific competencies adapted and/or added to the original Association of American Medical Colleges' (AAMC) Telehealth Competencies with permission from the AAMC. The first draft of the rheumatology TCs was shared at the 2021 ACR Convergence conference during the educators' community hub presentation, “Interactive Discussion: Telehealth Competencies and Curriculum” (13). This draft was also distributed electronically to recipients of the Rheumatology Research Foundation Clinician Scholar Educator (CSE) award. In these venues, over 100 clinicians and educators were invited to view the competencies and suggest edits for consideration in the 2022 rheumatology TCs. The working group co-chairs (LZ, JK, and MBB) recorded comments shared verbally during the 2021 educators' community hub and received 37 points of written feedback from 19 previous CSE award recipients. Using a collaborative process, the co-chairs considered each item, discussed its relevance to the 2022 rheumatology TCs, and decided together how best to incorporate the comment into the TCs. Additionally, all members of the working group approved these changes before finalizing the 2022 rheumatology TCs. The 2022 rheumatology TCs represent an initiative supported by the ACR and completed without performing research on human subjects. Therefore, the working group did not procure approval from an institutional review board prior to beginning its collaborative process.
Publisher Copyright:
© 2022 American College of Rheumatology.
PY - 2023/6
Y1 - 2023/6
N2 - Objective: Telehealth is an essential facet of care delivery for patients with rheumatic diseases. The Association of American Medical College's (AAMC) telehealth competencies (TCs) define the skills required for delivering general telehealth care across the range of clinician experience. In this study, the American College of Rheumatology's (ACR) TCs working group aimed to adapt the AAMC TCs to rheumatology, outlining the skills acquisition unique to rheumatology with a focus on knowledge, skills, and behaviors expected of recent rheumatology fellowship graduates. Methods: Through a collaborative process, the working group adapted the AAMC TCs to the training structure and practice of rheumatology. The rheumatology TCs underwent peer review among recipients of the Clinician Scholar Educator Award and attendees at the ACR 2021 Convergence conference. Results: The rheumatology TCs define 24 essential skills required for synchronous telehealth care of patients with rheumatic diseases. The working group adapted the AAMC's 20 TCs organized within 6 domains, added 2 skills to the AAMC's domains of patient safety and appropriate use, and data collection and assessment, and created a novel domain of systems-based requirements with 2 competencies. The rheumatology TCs define expected skill levels for recent rheumatology fellowship graduates and experienced rheumatology clinicians. Conclusion: The rheumatology TCs represent the first adaptation of the AAMC TCs to subspecialty care, expanding the scope to include rheumatology fellowship graduates and additional domains of rheumatology practice. These competencies can guide curricular innovations and measurements of proficiency in telehealth care delivery among rheumatology trainees and experienced clinicians, enhancing the care provided to patients with rheumatic diseases.
AB - Objective: Telehealth is an essential facet of care delivery for patients with rheumatic diseases. The Association of American Medical College's (AAMC) telehealth competencies (TCs) define the skills required for delivering general telehealth care across the range of clinician experience. In this study, the American College of Rheumatology's (ACR) TCs working group aimed to adapt the AAMC TCs to rheumatology, outlining the skills acquisition unique to rheumatology with a focus on knowledge, skills, and behaviors expected of recent rheumatology fellowship graduates. Methods: Through a collaborative process, the working group adapted the AAMC TCs to the training structure and practice of rheumatology. The rheumatology TCs underwent peer review among recipients of the Clinician Scholar Educator Award and attendees at the ACR 2021 Convergence conference. Results: The rheumatology TCs define 24 essential skills required for synchronous telehealth care of patients with rheumatic diseases. The working group adapted the AAMC's 20 TCs organized within 6 domains, added 2 skills to the AAMC's domains of patient safety and appropriate use, and data collection and assessment, and created a novel domain of systems-based requirements with 2 competencies. The rheumatology TCs define expected skill levels for recent rheumatology fellowship graduates and experienced rheumatology clinicians. Conclusion: The rheumatology TCs represent the first adaptation of the AAMC TCs to subspecialty care, expanding the scope to include rheumatology fellowship graduates and additional domains of rheumatology practice. These competencies can guide curricular innovations and measurements of proficiency in telehealth care delivery among rheumatology trainees and experienced clinicians, enhancing the care provided to patients with rheumatic diseases.
UR - http://www.scopus.com/inward/record.url?scp=85143285986&partnerID=8YFLogxK
U2 - 10.1002/acr.25023
DO - 10.1002/acr.25023
M3 - Article
C2 - 36121041
AN - SCOPUS:85143285986
SN - 2151-464X
VL - 75
SP - 1213
EP - 1219
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 6
ER -