Can telerheumatology improve rheumatic and musculoskeletal disease service delivery in sub-Saharan Africa?

We note with great interest the paper by Costa et al ,1 who submits that telemedicine has emerged as a key tool for managing psoriatic arthritis (PsA) among patients in Italy during the COVID-19 pandemic. The WHO has emphasised that universal health coverage cannot be achieved without the support of e-health of which telemedicine is a subset.2 In sub-Saharan Africa, there is a dearth of rheumatologists. Rheumatology services are mostly centred in urban tertiary academic hospitals despite the greater rheumatic and musculoskeletal disease (RMD) burden in rural communities.3 In an attempt to link technology and healthcare in the region, innovative tools for electronic data capture and clinical decision support have been developed with varying degrees of success.4 5 Telemedicine (also used interchangeably with telehealth) can be defined as the use of medical information that is exchanged from one site to another through electronic communication to improve a patient’s health.6 It has wide use in radiology, dermatology and psychiatry. Its usage in specialties like rheumatology (telerheumatology) appears to be increasing. Different telemedicine services exist. These include teleconsultation (synchronous or asynchronous), remote patient monitoring, as well as tele-education (online continuing medical education). Key advantages include convenience, …