THE EXPERIENCE OF A RHEUMATOLOGY UNIT DURING THE COVID19 LOCKDOWN: TELEMEDICINE ALLOWS A SAFE FOLLOW UP OF PATIENTS WITH RHEUMATIC DISEASES

Background: In March this year, most of the routine activities were cancelledduring the streaming of the pandemic in Italy. This prompted a pragmatic reorganization of the traditional care model of nursing and medicine, to quickly givean efficient clinical response. During the first phase of the pandemic, outpatientvisits dropped by more than 60%, forcefully shifting to telemedicine to assurecontinuity of care despite the lockdown.Objectives: The aim of the present work was to describe the strategy adopted duringand immediately after the lockdown to assure the follow up of patients and the maintenance of their treatment in an outpatient “virtual” telemedicine clinic dedicated to RDs.Methods: the patient flow to a rheumatology division during the lockdown wasevaluated retrospectively from March to September 2020 in accordance withlocal restrictions, and three periods are described.Results: 653/913 (71.5%), 542/542 (100%) and 1.048/1.048 (100%) infusionactivities scheduled were performed at the centre for daily infusion and pre-infusion assessment, respectively during the 1st, 2nd and 3rd period. In the outpatientclinic during the 1st period, 96.96% of the cases was shifted to Telemedicine,which decreased to 52.45% in the 2nd period; while in the 3rd period, 97.6% ofthe performances were carried out at the clinic. Diagnostic procedures, such asultrasound, capillaroscopy, and joint injection were generally postponed duringthe 1st period, reduced drastically during the 2nd and performed regularly during 3rd period. Ulcer treatment and the Clinical Trial Unit never stopped their activity.The flow of the activity of the outpatient clinic and the day hospital is representedas monthly trends in graph 1 (See Graph 1).Conclusion: Our data show the feasibility of Telemedicine in a lockdown condition. Shifting stable patients to Telemedicine has the potentiality to minimize therisk of contagion and allow continuity of care. In the future, the use of Telemedicine for specific clinical uses might assure patient assistance also in non-pandemic conditions