{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T09:01:47Z","timestamp":1793091707403,"version":"4.5.0"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T00:00:00Z","timestamp":1747872000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Health Serv."],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>There 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fourteen 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/frhs.2025.1503881","type":"journal-article","created":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T01:26:44Z","timestamp":1747877204000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Telemedicine for under-resourced patients with systemic lupus erythematosus: a qualitative study exploring the views and experiences of patients and their healthcare team"],"prefix":"10.3389","volume":"5","author":[{"given":"Savannah","family":"Bowman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandeep K.","family":"Agarwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keshia C.","family":"Ferguson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maryjo J.","family":"Maliekel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria A.","family":"Lopez-Olivo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Suarez-Almazor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria I.","family":"Danila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinoos","family":"Yazdany","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Bruera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,5,22]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1136\/annrheumdis-2020-216924","article-title":"2019 update of the joint European league against rheumatism and European renal association\u2013European dialysis and transplant association (EULAR\/ERA\u2013EDTA) recommendations for the management of lupus nephritis","volume":"79","author":"Fanouriakis","year":"2020","journal-title":"Ann Rheum Dis"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12913-018-3429-7","article-title":"Improvement of appointment compliance in an underserved lupus clinic","volume":"18","author":"Kumthekar","year":"2018","journal-title":"BMC Health Serv Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"561","DOI":"10.1191\/0961203304lu1061oa","article-title":"Relationship between adherence to study and clinic visits in systemic lupus erythematosus patients: data from the LUMINA cohort","volume":"13","author":"Uribe","year":"2004","journal-title":"Lupus"},{"key":"B4","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1191\/096120300678828785","article-title":"Lupus patients in an emergency unit. Causes of consultation, hospitalization and outcome. A cohort study","volume":"9","author":"Rojas-Serrano","year":"2000","journal-title":"Lupus"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1144","DOI":"10.1093\/rheumatology\/kel039","article-title":"An assessment of renal failure in an SLE cohort with special reference to ethnicity, over a 25-year period","volume":"45","author":"Adler","year":"2006","journal-title":"Rheumatology"},{"key":"B6","doi-asserted-by":"publisher","first-page":"488","DOI":"10.1177\/09612033221084515","article-title":"Use of telemedicine for follow-up of lupus nephritis in the COVID-19 outbreak: the 6-month results of a randomized controlled trial","volume":"31","author":"So","year":"2022","journal-title":"Lupus"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1911","DOI":"10.1093\/rheumatology\/keab694","article-title":"Impact of teleconsultation on subsequent disease activity and flares in patients with systemic lupus erythematosus","volume":"61","author":"Au Eong","year":"2022","journal-title":"Rheumatology"},{"key":"B8","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1016\/j.amjms.2022.06.021","article-title":"Satisfaction with modes of telemedicine delivery during COVID-19: a randomized, single-blind, parallel group, noninferiority trial","volume":"364","author":"Danila","year":"2022","journal-title":"Am J Med Sci"},{"key":"B9","doi-asserted-by":"publisher","first-page":"1049","DOI":"10.1002\/acr.24860","article-title":"Patient perceptions and preferences regarding telemedicine for autoimmune rheumatic diseases care during the COVID-19 pandemic","volume":"74","author":"Danila","year":"2022","journal-title":"Arthritis Care Res"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1097\/ACM.0000000000000388","article-title":"Standards for reporting qualitative research: a synthesis of recommendations","volume":"89","author":"O\u2019Brien","year":"2014","journal-title":"Acad Med"},{"key":"B11","year":"2024"},{"key":"B12","doi-asserted-by":"publisher","first-page":"e49065","DOI":"10.2196\/49065","article-title":"Telemedicine for patients with systemic lupus erythematosus in a publicly funded hospital system: retrospective study","volume":"13","author":"Bruera","year":"2024","journal-title":"Interact J Med Res"},{"key":"B13","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/1525822X05279903","article-title":"How many interviews are enough? An experiment with data saturation and variability","volume":"18","author":"Guest","year":"2006","journal-title":"Field Methods"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1002\/art.40930","article-title":"2019 European league against rheumatism\/American college of rheumatology classification criteria for systemic lupus erythematosus","volume":"71","author":"Aringer","year":"2019","journal-title":"Arthritis Rheumatol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"1615","DOI":"10.1136\/annrheumdis-2015-207726","article-title":"Definition and initial validation of a lupus low disease activity state (LLDAS)","volume":"75","author":"Franklyn","year":"2016","journal-title":"Ann Rheum Dis"},{"key":"B16","doi-asserted-by":"publisher","first-page":"1155","DOI":"10.1080\/08897077.2022.2060447","article-title":"A qualitative study of patient experiences with telemedicine opioid use disorder treatment during COVID-19","volume":"43","author":"Lockard","year":"2022","journal-title":"Subst Abus"},{"key":"B17","doi-asserted-by":"publisher","first-page":"507","DOI":"10.3122\/jabfm.2022.03.210229","article-title":"Telemedicine in primary care: qualitative work towards a framework for appropriate use","volume":"35","author":"Segal","year":"2022","journal-title":"J Am Board Fam Med"},{"key":"B18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1475-9276-12-18","article-title":"Patient-centred access to health care: conceptualising access at the interface of health systems and populations","volume":"12","author":"Levesque","year":"2013","journal-title":"Int J Equity Health"},{"key":"B19","doi-asserted-by":"publisher","first-page":"5087","DOI":"10.1007\/s10067-021-05759-8","article-title":"Ability and willingness to utilize telemedicine among rheumatology patients\u2014a cross-sectional survey","volume":"40","author":"Kong","year":"2021","journal-title":"Clin Rheumatol"},{"key":"B20","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1089\/tmj.2020.0525","article-title":"The impact of telehealth implementation on underserved populations and no-show rates by medical specialty during the COVID-19 pandemic","volume":"27","author":"Franciosi","year":"2021","journal-title":"Telemed J E Health"},{"key":"B21","doi-asserted-by":"publisher","first-page":"e001548","DOI":"10.1136\/rmdopen-2020-001548","article-title":"Digital rheumatology in the era of COVID-19: results of a national patient and physician survey","volume":"7","author":"Kernder","year":"2021","journal-title":"RMD Open"},{"key":"B22","doi-asserted-by":"publisher","first-page":"262","DOI":"10.1097\/BOR.0000000000000790","article-title":"Telerheumatology: before, during, and after a global pandemic","volume":"33","author":"Matsumoto","year":"2021","journal-title":"Curr Opin Rheumatol"},{"key":"B23","year":"2021"},{"key":"B24","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12969-016-0116-2","article-title":"Decreasing patient cost and travel time through pediatric rheumatology telemedicine visits","volume":"14","author":"Kessler","year":"2016","journal-title":"Pediatr Rheumatol"},{"key":"B25","first-page":"1f","article-title":"Privacy and security risk factors related to telehealth services\u2014a systematic review","volume":"20","author":"Houser","year":"2023","journal-title":"Perspect Health Inf Manag"},{"key":"B26","doi-asserted-by":"publisher","first-page":"2262","DOI":"10.1093\/rheumatology\/keab796","article-title":"Telemedicine in rheumatology: a mixed methods study exploring acceptability, preferences and experiences among patients and clinicians","volume":"61","author":"Sloan","year":"2022","journal-title":"Rheumatology"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1480","DOI":"10.3899\/jrheum.090726","article-title":"Male-only systemic lupus","volume":"37","author":"Aggarwal","year":"2010","journal-title":"J Rheumatol"}],"container-title":["Frontiers in Health Services"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2025.1503881\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,22]],"date-time":"2025-05-22T01:26:45Z","timestamp":1747877205000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frhs.2025.1503881\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,22]]},"references-count":27,"alternative-id":["10.3389\/frhs.2025.1503881"],"URL":"https:\/\/doi.org\/10.3389\/frhs.2025.1503881","relation":{},"ISSN":["2813-0146"],"issn-type":[{"value":"2813-0146","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,22]]},"article-number":"1503881"}}