Box 2.

Inclusion and exclusion criteria for teleclinics

Inclusion criteria
  • Patients whose condition is clinically stable with low disease activity scores, who are making good progress and doing well on disease modifying drugs (DMARDs) or biologics

  • Patients who already have a wide appointment interval, eg 12 months, and in whom not much new has happened between appointments

  • Patients requiring discussion of test results and proposed treatments/drugs after initial appointment

  • Osteoporosis referrals where patients require interpretation of DEXA and advice about treatment

  • Alternate clinics for patients requiring monthly escalation for early inflammatory arthritis

  • Patients requesting to be seen earlier than their set appointment – this allows accurate assessment of the degree of urgency required

  • Patients on remote monitoring who are completing their outcome scores online and with low disease activity

  • Patients not suitable for patient-initiated follow up, where a teleclinic will enable assessment of their condition

Exclusion criteria
  • Patients who decline to have teleconsultation

  • Patients not in a location where they can speak confidentially

  • New patients being referred with a new problem; they should have face-to-face (FTF) appointments unless there is a good reason for a teleclinic (eg symptoms suggest that accurate advice can be given in a teleclinic)

  • Patients with new symptoms that need clinical examination for accurate evaluation

  • Patients with existing conditions that need clinical examination for meaningful assessment, eg swollen joint counts in rheumatoid arthritis

  • Situations where patient confidence requires FTF consultation even if appropriate decisions could be made in a teleclinic. Often such patients require the reassurance of a clinical examination

  • Children under the age of 18, unless a parent or guardian is available, and vulnerable adults

  • Patients who are unable to use or access IT or phone

  • Patients with communication difficulties, eg speech/hearing impairments, poor English if independent interpreter service not accessible

  • Patients with impaired cognition, unless a relative or friend is available to speak on patient's behalf with patient's adequate consent