Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team

ObjectivesThere is scarce knowledge on the benefits, limitations, and acceptance of telemedicine in patients with systemic lupus erythematosus (SLE), particularly in those from under-resourced groups. We aimed to assess the experiences and views on telemedicine of people with SLE, clinicians, and nu...

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Main Authors: Savannah Bowman, Sandeep K. Agarwal, Keshia C. Ferguson, Maryjo J. Maliekel, Maria A. Lopez-Olivo, Maria E. Suarez-Almazor, Maria I. Danila, Jinoos Yazdany, Sebastian Bruera
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Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Health Services
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Online Access:https://www.frontiersin.org/articles/10.3389/frhs.2025.1503881/full
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author Savannah Bowman
Sandeep K. Agarwal
Keshia C. Ferguson
Maryjo J. Maliekel
Maria A. Lopez-Olivo
Maria E. Suarez-Almazor
Maria I. Danila
Maria I. Danila
Jinoos Yazdany
Sebastian Bruera
author_facet Savannah Bowman
Sandeep K. Agarwal
Keshia C. Ferguson
Maryjo J. Maliekel
Maria A. Lopez-Olivo
Maria E. Suarez-Almazor
Maria I. Danila
Maria I. Danila
Jinoos Yazdany
Sebastian Bruera
author_sort Savannah Bowman
collection DOAJ
description ObjectivesThere is scarce knowledge on the benefits, limitations, and acceptance of telemedicine in patients with systemic lupus erythematosus (SLE), particularly in those from under-resourced groups. We aimed to assess the experiences and views on telemedicine of people with SLE, clinicians, and nursing staff from a safety net healthcare system in Harris County, Texas, defined as a hospital network that primarily serves low-income, uninsured, and vulnerable populations.MethodsWe conducted semi-structured 1:1 in-person interviews of patients with SLE and their clinical team members, in Harris County, Texas. Using Levesque's conceptual framework for healthcare access, semi-structured interviews and content analysis were used to explore benefits and limitations of telemedicine in under-resourced patients with SLE. Interview content was coded using inductive and deductive approaches. Data collected proceeded until thematic saturation was reached. Themes and subthemes were identified and visualized.ResultsFourteen interviews were conducted. The participants included six patients with SLE, three rheumatologists, two nurses, two medical assistants, and one rheumatology fellow. All participants had previously participated in telemedicine visits. One hundred and fifty-one codes were identified. Five key themes emerged from the analysis, including: (1) Access and Convenience, (2) Technological and Linguistic Barriers, (3) Economic Considerations, (4) Quality of Care and Disease Outcomes, and (5) Implementation of Telemedicine. Analysis showed that telemedicine could improve access to care and adherence to clinic visits by reducing the barriers associated with socioeconomic factors. On the other hand, barriers to telemedicine included digital literacy, concern about negative impact on physician-patient relationship, and language discordance.ConclusionThere is an opportunity to improve access to care in patients with SLE, particularly from under-resourced backgrounds, by leveraging the benefits of telemedicine with respect to access to care, while addressing the barriers to successful implementation.
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spelling doaj-art-25db56b27d514746b2648c5c76d9d2ce2025-08-20T02:25:40ZengFrontiers Media S.A.Frontiers in Health Services2813-01462025-05-01510.3389/frhs.2025.15038811503881Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare teamSavannah Bowman0Sandeep K. Agarwal1Keshia C. Ferguson2Maryjo J. Maliekel3Maria A. Lopez-Olivo4Maria E. Suarez-Almazor5Maria I. Danila6Maria I. Danila7Jinoos Yazdany8Sebastian Bruera9Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, United StatesSection of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, United StatesSection of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, United StatesSection of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, United StatesDepartment of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDepartment of Health Services Research, University of Texas MD Anderson Cancer Center, Houston, TX, United StatesDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, United StatesBirmingham Atlanta Geriatrics Research Education and Clinical Center (GRECC), Birmingham VA Medical Center, Birmingham, AL, United StatesDivision of Rheumatology, Universityof California, San Francisco, CA, United StatesSection of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, United StatesObjectivesThere is scarce knowledge on the benefits, limitations, and acceptance of telemedicine in patients with systemic lupus erythematosus (SLE), particularly in those from under-resourced groups. We aimed to assess the experiences and views on telemedicine of people with SLE, clinicians, and nursing staff from a safety net healthcare system in Harris County, Texas, defined as a hospital network that primarily serves low-income, uninsured, and vulnerable populations.MethodsWe conducted semi-structured 1:1 in-person interviews of patients with SLE and their clinical team members, in Harris County, Texas. Using Levesque's conceptual framework for healthcare access, semi-structured interviews and content analysis were used to explore benefits and limitations of telemedicine in under-resourced patients with SLE. Interview content was coded using inductive and deductive approaches. Data collected proceeded until thematic saturation was reached. Themes and subthemes were identified and visualized.ResultsFourteen interviews were conducted. The participants included six patients with SLE, three rheumatologists, two nurses, two medical assistants, and one rheumatology fellow. All participants had previously participated in telemedicine visits. One hundred and fifty-one codes were identified. Five key themes emerged from the analysis, including: (1) Access and Convenience, (2) Technological and Linguistic Barriers, (3) Economic Considerations, (4) Quality of Care and Disease Outcomes, and (5) Implementation of Telemedicine. Analysis showed that telemedicine could improve access to care and adherence to clinic visits by reducing the barriers associated with socioeconomic factors. On the other hand, barriers to telemedicine included digital literacy, concern about negative impact on physician-patient relationship, and language discordance.ConclusionThere is an opportunity to improve access to care in patients with SLE, particularly from under-resourced backgrounds, by leveraging the benefits of telemedicine with respect to access to care, while addressing the barriers to successful implementation.https://www.frontiersin.org/articles/10.3389/frhs.2025.1503881/fulltelemedicinesystemic lupus—erythematosussocioeconomic disparityqualitativethematic analyses
spellingShingle Savannah Bowman
Sandeep K. Agarwal
Keshia C. Ferguson
Maryjo J. Maliekel
Maria A. Lopez-Olivo
Maria E. Suarez-Almazor
Maria I. Danila
Maria I. Danila
Jinoos Yazdany
Sebastian Bruera
Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team
Frontiers in Health Services
telemedicine
systemic lupus—erythematosus
socioeconomic disparity
qualitative
thematic analyses
title Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team
title_full Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team
title_fullStr Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team
title_full_unstemmed Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team
title_short Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team
title_sort telemedicine for under resourced patients with systemic lupus erythematosus a qualitative study exploring the views and experiences of patients and their healthcare team
topic telemedicine
systemic lupus—erythematosus
socioeconomic disparity
qualitative
thematic analyses
url https://www.frontiersin.org/articles/10.3389/frhs.2025.1503881/full
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