Evaluation of a rural telerheumatology service in the Gilgit-Baltistan region of Pakistan: patient and physician experience.

Between April 2022 and April 2023, our group conducted a pilot telerheumatology service. Physicians at a major rheumatology centre in Islamabad consulted for patients in a rural centre in the Gilgit-Baltistan region. To better understand both the patient and physician experience from this telerheumatology service, we conducted surveys of patients who participated in our program, as well as the three rheumatologists who provided telerheumatology services in this program. Of 218 respondents, 125 (57.3%) were female, and 195 (89.4%) were Balti in ethnicity. The average respondent age was 47 ± 15 years. Satisfaction among patients was gauged on a Likert scale from 1 to 5, and the median scores (95% confidence interval) were: usefulness 4 (4.25-4.42), ability to communicate effectively 4 (3.59-3.84), overall satisfaction with consultation 4 (4.16-4.33), perceived health improvement 5 (4.53-4.68), and intention to re-consult 5 (4.73-4.85). Provider satisfaction was moderate, with network instability and language barriers cited as major concerns. Providers expressed satisfaction in being able to care for otherwise inaccessible patients. Despite limited resources, and in the absence of specialist care in the Gilgit-Baltistan region, our telerheumatology program achieved high patient satisfaction and moderate provider satisfaction, demonstrating the potential of telemedicine to improve access to care in underserved rural regions. Addressing communication barriers and technical limitations will be crucial for optimizing the impact of such programmes in the future.