Teletherapy via videoconferencing appears to be just as effective in treating patients with Parkinson’s disease as traditional in-person therapy, according to a new study published in the journal Neurology.
The two greatest barriers to appropriate care for Parkinson’s patients are distance and disability. Most physicians who specialize in movement disorders are located in academic medical centers in large urban areas, while most patients tend to live in suburban and rural areas. Patients who have impaired mobility and driving ability are faced with the added challenge of making frequent trips to the doctor’s office — a task that becomes more difficult as the disease progresses.
In fact, an estimated 40 percent of people with Parkinson’s disease do not see a neurologist soon after diagnosis. This puts them at a much greater risk of falls leading to hip fractures, ending up in a nursing home or hospital, and even death. As the population ages, the challenge of providing care for all of these individuals will become ever greater, as it is projected that the number of people with Parkinson’s disease will double by 2030.
The findings are based on the Connect.Parkinson project, a nationwide program that links neurologists with remote Parkinson’s patients.
The aim of the study was to determine whether telemedicine would allow neurologists to deliver care to patients in the comfort of their homes. A total of 195 individuals with Parkinson’s were selected to participate in the study. Patients either received care through their primary care physician or had that care supplemented with up to four visits via video conference with a neurologist they had not seen before.
Parkinson’s disease particularly lends itself to telemedicine because many aspects of the diagnosis and treatment of the disease are “visual,” meaning that the interaction with the doctor mainly involves listening to the patient and observing them perform certain tasks such as holding their hands out or walking.
The researchers found that the telemedicine visits were just as effective as in-person visits in the doctor’s office, with the quality of life reported by the participants as no better or worse for people who received care in their homes compared with those who received standard care. In fact, the virtual house calls saved patients an average of 169 minutes and nearly 100 miles of travel per visit.
“Virtual house calls for chronic diseases like Parkinson’s are not only as effective as in-person care but broader adoption of this technology has the potential to expand access to patient-centered care,” said Ray Dorsey, M.D., the David M. Levy Professor of Neurology at the University of Rochester Medical Center (URMC) and lead author of the study.
“We now have the ability to reach anyone, anywhere but the promise and benefits of telemedicine will not be fully realized until the changes are made in Medicare policy.”
Unfortunately, widespread adoption of this technology is hindered by federal healthcare policies. Approximately two-thirds of Parkinson’s patients are on Medicare which does not reimburse for in-home telemedicine care. Legislation has been introduced in Congress to allow Medicare to expand reimbursement for telemedicine.
“We can shop, bank, make travel reservations, take classes, and buy groceries via the internet from the comfort of our own homes, but too many patients still cannot access health care,” said Dorsey.
“Telemedicine is an option if you are a veteran, a member of the Armed Services, a Medicaid beneficiary, or a Canadian, but not if you have a chronic condition and are a Medicare beneficiary.”