Rheumatologists have a critical role to play in optimizing the response to COVID-19 and outcomes for our patients with rheumatic diseases. In just the past few weeks, rheumatologists at Brigham and Women’s Hospital and around the world have joined forces for this purpose.
“I’ve been very impressed by how quickly the rheumatology community has come together,” said rheumatologist Susan Y. Ritter, MD, PhD, associate medical director of the Brigham’s Arthritis Center. “I’ve seen multiple people communicating via email, Twitter and Facebook to get the word out to rheumatologists and make sure we have as much data as possible.”
Launching an International Alliance
Among the most remarkable of these efforts is the rapid formation of the COVID-19 Global Rheumatology Alliance. The Alliance sprang up as the result of conversations that rheumatologists across the globe were having via social media.
Indeed, social media has been a valuable communication tool within the rheumatology community throughout this crisis. For example, the Twitter feed of the American College of Rheumatology, @ACRheum, includes practice updates on such topics as infusion guidance, utilizing telehealth and scarce resource allocation during the COVID-19 pandemic. Jeffrey A. Sparks, MD, is one Brigham rheumatologist who has been particularly active in posting research news on his Twitter feed, @jeffsparks.
For her part, Dr. Ritter has turned to several physicians’ groups on Facebook for discussions and advice about COVID-19. “There’s a lot online for physicians to be able to share ideas and what they’re seeing in real time,” she said.
Collaboration Within the Brigham
One way that rheumatologists at the Brigham’s Division of Rheumatology, Inflammation and Immunity are collaborating in the COVID-19 era involves call schedules. Leadership has identified those who would be at risk in the hospital setting—e.g. older or pregnant staff members—and then asked for volunteers to be on call.
“We’ve arranged for the inpatient consult service to have rotations of no longer than five days at a time, with a first call person and a backup person in case that person gets sick,” Dr. Ritter explained. “In clinic, there’s a different doctor of the day, again with a backup person in case that person gets sick. The same goes for the fellows’ schedule.
“Our goal is to minimize having to scramble at the last minute, so if somebody does get coronavirus, we have that schedule built in.”
Staff members working at home, meanwhile, are handling phone and video calls with patients. The hospital and division have created tip sheets and educational videos with instructions on topics such as using the Brigham’s electronic medical records system, creating shared language to reply to common questions and documenting virtual visits.
“Particularly for immunosuppressed patients, we’re trying to do all routine care remotely,” Dr. Ritter said. “Also, we have some multispecialty clinics at the Brigham that would usually have several doctors coming in and seeing the same patient at one time. So we’re determining how to provide that care that via videoconference.”
While an endless array of challenges is sure to emerge in the coming weeks and months, Dr. Ritter is optimistic about one potential upside. “This pandemic has really forced us to think about virtual care in ways we hadn’t considered before,” she concluded. “I think we’re going to become much more comfortable with it, and that’s really going to help people in the long run.”