By definition of the World Health Organization (WHO), e-health relates to the use of information and communication technologies for health services. This incorporates digital patient charts, access to their respective health records by the patient and treating physicians as well as medical apps (applications) for monitoring of health parameters and interacting with health care professionals and peers. The use and initiatives and legislations concerning e-health have become increasingly wide spread across the world. With the continued popularity of smartphones in recent years, both smartphone applications and social media are progressively used. In 2018, worldwide users of social media were estimated at 3.196 billion, accounting for 42% of the global population. Social media use has grown enormously in the last decade, with a plus of 13% in 2017 alone. More than half and two thirds of the world's population are connected to the internet and having a mobile phone respectively. The roll-out of mobile solutions, affordable smartphones and broadband internet in remote areas on the globe allow for quicker and more specialised medical encounters. These developments enable people also to conveniently interact, access knowledge and take part in continued medical education regardless of geographical location. Mobile health (m-health) services range from toll free emergency numbers or health call centres (available in 75% of WHO countries) to treatment adherence and surveillance programs (48% of WHO countries). Fields, like radiology apply telehealth already very successfully, which leads to greater health equity globally. Therefore, e-health provides people with health conditions, particularly chronic conditions such as rheumatic and musculoskeletal diseases (RMDs), with new opportunities to identify information about their disease and treatment, as well as the ability to connect.

The use of e-health solutions for collecting patient reported outcomes (PRO) enables patients to more realistically depict on how they are doing over time, provides better comparisons and changes the dynamic of feedback and the potential most appropriate time point for clinical encounters. Online health users with rheumatoid arthritis do currently however not represent the general population of people with RA, since there are more often younger, do have shorter disease duration and live in rural areas. At the same time, they define an additional group for clinical trials and have a high willingness to participate, which outlines new avenues for recruitment of patients into trials. Still, continued constant use of m-health applications is less common. One third of people that started using a mobile health app are using it on daily or weekly basis. The use of apps does not always coincide with better outcomes as could be shown in a trial incorporating people with poorly controlled hypertension. This indicates, despite all positive developments and opportunities over the last decade, that there is still a long way ahead to tailor e-health initiatives to result in more optimised work flows for health care professionals and better health management for everyone.

Disclosure of Interests: None declared

DOI: 10.1136/annrheumdis-2019-eular.8596