Dr. Johannes Knitza, a leading figure in digital treatment technology in the rheumatology field, gave an interesting talk at the WP5 summer seminar. The topic was where research in the digital area stands today and the direction for the future. Inger Jorid Berg and Emily V. Langballe presented exciting Norwegian research in the area.
WP5 is entitled Innovative approaches.
ReMonit
Researcher and rheumatologist, Inger Jorid Berg, presented the interesting results from the ReMonit study. The study shows that both digital home monitoring and patient-directed monitoring can save healthcare resources, without compromising patient safety or satisfaction.
This could provide more flexible and efficient healthcare services for patients with chronic diseases. Read more about the results on our website!
Digital home monitoring of patients with interstitial lung disease (ILD)
Emily V. Langballe is a specialist in rheumatology and PhD fellow at Oslo University Hospital (OUS), Rikshospitalet.
The research project Nor-mILDer investigates digital home monitoring for patients with ILD caused by systemic rheumatic diseases, such as systemic sclerosis, rheumatoid arthritis, Sjögren's syndrome, antisynthetase syndrome and MCTD.
Nor-mILDer is a randomized multicenter clinical trial with participants from Norway, Switzerland and Romania. The study compares traditional hospital monitoring with digital home monitoring over one year. Patients are randomly divided into two groups.
The study uses technologies such as MediTuner (formerly AsthmaTuner) to conduct breathing tests. The goal is to assess whether digital home monitoring can detect disease exacerbations earlier and more accurately than traditional monitoring.
Rheumatology in the digital health era: status quo and quo vadis?
Johannes Knitza gave an overview of the status of the rheumatology field and thoughts on the way forward – based on his recent article in Nature Review Rheumatology. As one of Europe's most influential researchers in digital rheumatology, Knitza is leading the way in the development of artificial intelligence and digital tools in patient care.
In the article Rheumatology in the digital health era: status quo and quo vadis? he argues that the field of rheumatology is facing a critical shortage of healthcare personnel. An aging patient population is leading to more people with rheumatological diseases and thus increasing costs. This will lead to greater gaps in healthcare provision.
Innovation and clinical practice
He sees the explosive development of digital health technologies (DHT) over the past five years as providing new opportunities to address these challenges and contributing to better healthcare services overall. However, keeping up with the innovations and integrating them into clinical practice can be challenging.
In the seminar, he said that for five years now, patients in Germany have had the opportunity to get a prescription for DIGAs, apps that can help them with anxiety, depression, back pain, weight control, etc.
Although studies show that an overwhelming 80 percent of patients considered such digital tools useful and easy to use, he mentioned a number of challenges.
One of them was related to payment models: Health insurance companies were reluctant to facilitate use. Another challenge was that healthcare professionals were not as informed about them or had as much faith that this was "good medicine". "It's just an app". A third challenge was that such apps can be so expensive (from 250 to 2000 €) that doctors would not prescribe them. It is also a challenge that patients do not use the apps as intended (adherence).
- It's getting there, but very slowly, he said.
Digital transformation
Knitza has explored the transformative potential of DHT in rheumatology – how the technology can change the entire patient journey and redefine the roles of both patients and providers – and discusses potential barriers to integrating DHT.
He sees technologies that can be used throughout the patient journey. These include large language models, decision support systems, digital treatment tools, electronic patient-reported data, digital biomarkers, robots, self-sampling equipment, and artificial intelligence-based note-taking systems.
In the seminar, he pointed out how language models could in many cases provide just as good answers to medical questions as rheumatologists. He gave several examples of which language models worked and which were not as useful.
His team is working on developing language models that prevent patient information from being lost, enabling more personalized and continuous healthcare through a digital safety net.
He envisions how a "digital-first" hybrid process, with step-by-step treatment, could combine physical attendance and digital follow-up.
Knitza also touched on the benefits and risks that come with developing the traditional relationship between patient and practitioner into a "digital health triad" in which technology plays an active role.
– To succeed in this new digital health landscape – and truly take advantage of the potential of digital health technologies for better rheumatology treatment – collaboration between different professional communities is crucial, he says.
Read the article in pubmed:
Rheumatology in the digital health era: status quo and quo vadis? - PubMed
Johannes Knitza, Latika Gupta, Thomas Hügle
PMID: 39482466 | DOI: 10.1038/s41584-024-01177-7
