THU0645 VIRTUAL VISITS IS THE FUTURE COMING? TELEREUMATOLOGY. PILOT PROJECT: REVIR PROGRAM, RHEUMATOLOGY SERVICE. BARCELONA, SPAIN
Authors: Fabiola Ojeda, Manel Ciria, Carolina Perez-Garcia, Eric Sitjas, Elena Martinez, Daniel Martinez-Laguna, Montserrat Pimienta, Jordi Monfort
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background:</h3> The prevalence of rheumatic diseases in the Spanish population is estimated at 22.6% according to the EPISER 2000 study. A new epidemiological study is currently underway, EPISER 2016 and its preliminary results point towards a higher prevalence. Within the national health system, primary care is the first level of access to the health system and is provided at primary care centers (CAP). The rheumatology at primary care centers at Spain has been a pioneer in the application from the team at Parc de Salut Mar (Hospital del Mar), with the physical presence of rheumatologists in the 14 centers belonging to the CAP network of the SAP Litoral. The high prevalence of the medical pathology of the musculoskeletal syste and the aging of the population, can condition an increase in visit requests in rheumatology, and with it, the increase in the waiting lists of patients. <h3>Objectives:</h3> The main objective of this study is to know the resolutive possibility of virtualization, measured in the number of visits resolved telematically, as well as its impact on the resolution capacity of the primary care physician and the reduction of the waiting list of first face-to-face visits. <h3>Methods:</h3> Prospective experimental study, started on December 1, 2017 and ended on May 31, 2018. Four primary care centers were selected according to population and waiting list: Sant Martí Nord, Sant Martí Sud, Ramón Turró and Villa Olímpica. The REVIR program proposes the creation of a circuit for the assessment of referrals to rheumatology from primary care physicians (MAP). <h3>Results:</h3> 726 first visit requests were received during the REVIR program. The most common categorized pathology was mechanical pathology, representing about 70% of the first visits requested. Metabolic bone disease ranked second with 16%, and inflammatory pathology ranked third (SLE, RA, SA, SPA, PsA). Chronic musculoskeletal pain ranked fourth (including fibromyalgia) and lastly soft tissue pathology. The number of first visit requests was multiplied by two in all the participating primary care centers of the project. Despite this increase, the telematic resolution of the visits created was stable, with a value greater than 40%. <h3>Conclusion:</h3> The implementation of a system of assessment of the first visits in rheumatology requested from Primary Care is effective in decreasing the waiting list to make face-to-face visits, as well as to detect early serious pathology that requires hospital control. It has been achieved, therefore, that the patient is treated at the level of attention that corresponds to him. Guaranteeing the adequate use of hospital resources and reducing the waiting list for a first in-person visit in rheumatology in primary care is one of the most important goals fulfilled, given that it is directly related to maintaining the accessibility and equity of the public health system. <h3>References:</h3> [1] Kataria, S., &amp; Ravindran, V. (2018). Digital health: a new dimension in rheumatology patient care. Rheumatology International. https://doi.org/10.1007/s00296-018-4037- <h3>Disclosure of Interests:</h3> Fabiola Ojeda: None declared, Manel Ciria: None declared, Carolina Perez-Garcia: None declared, Eric Sitjas: None declared, Elena Martinez: None declared, Daniel Martinez-Laguna Speakers bureau: Eli Lilly, Amgen, Ferrer, Rubió and Novartis., Montserrat Pimienta: None declared, Jordi Monfort: None declared