Telemedicine Interest for Routine Follow-Up Care Among Neurology Patients in Arkansas

Bashiri, Maryam; Greenfield, Lazar J.; Oliveto, Alison

doi:10.1089/tmj.2015.0112

Cited by 23 publications

(24 citation statements)

References 42 publications

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“…Similar to previous outpatient teleneurology studies [26][27][28], our pilot consistently received excellent satisfaction scores. Patients preferred to follow-up in the tele-PN clinic over our closest in-person neurology clinic 86% of the time, with the remaining 14% having no preference.…”

Section: Discussionsupporting

confidence: 78%

Teleneurology clinics for polyneuropathy: a pilot study

et al. 2019

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Introduction Polyneuropathy (PN) is a common condition with significant morbidity. We developed tele-polyneuropathy (tele-PN) clinics to improve access to neurology and increase guideline-concordant PN care. This article describes the mixedmethods evaluation of pilot tele-PN clinics at three community sites within the Greater Los Angeles VA Healthcare System. Methods For the first 25 patients (48 scheduled visits), we recorded the duration of the tele-PN visit and exam; the performance on three guideline-concordant care indicators (PN screening labs, opiate reduction, physical therapy for falls); and patient-satisfaction scores. We elicited comments about the tele-PN clinic from patients and the clinical team. We combined descriptive statistics with qualitative themes to determine the feasibility and acceptability of the tele-PN clinics. Results The average tele-PN encounter and exam times were 28.5 and 9.1 min, respectively. PN screening lab completion increased from 80 to 100%. Opiate freedom improved from 68 to 88%. Physical therapy for patients with recent falls increased from 58 to 100%. The tele-PN clinic was preferred for follow-up over in-person clinics in 86% of cases. Convenience was paramount to the clinic's success, saving an average of 231 min per patient in round-trip travel. The medical team's caring and collaborative spirit received high praise. While the clinic's efficiency was equal or superior to in-person care, the limited treatment options for PN and the small clinical exam space are areas for improvement. Conclusion In this pilot, we were able to efficiently see and examine patients remotely, promote guideline-concordant PN care, and provide a high-satisfaction encounter.

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Section: Discussionsupporting

confidence: 78%

Teleneurology clinics for polyneuropathy: a pilot study

et al. 2019

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“…A national movement in this direction would be facilitated by the creation of payor ‘telemedicine-in-the- home’ billing codes and changes in licensure laws that currently restrict crossing state lines with this technology. Studies suggest that persons with ALS who use telemedicine have decreased emergency room visits and hospital admissions, save on travel-related expenses, and are generally satisfied with their care, among other benefits ( 31 – 33 ). However, even telemedicine has its limitations (e.g.…”

Section: Discussionmentioning

confidence: 99%

A spatial analysis of amyotrophic lateral sclerosis (ALS) cases in the United States and their proximity to multidisciplinary ALS clinics, 2013

Horton

Graham

Punjani

et al. 2017

Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration

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Background Amyotrophic lateral sclerosis (ALS) is a fatal motor neuron disease that typically results in death within 2–5 years of initial symptom onset. Multidisciplinary ALS clinics (MDCs) have been established to provide specialty care to people living with the disease. Objective To estimate the proximity of ALS prevalence cases to the nearest MDC in the US to help evaluate one aspect of access to care. Methods Using 2013 prevalence data from the National ALS Registry, cases were geocoded by city using geographic information system (GIS) software, along with the locations of all MDCs in operation during 2013. Case-to-MDC proximity was calculated and analyzed by sex, race, and age group. Results During 2013, there were 72 MDCs in operation in 30 different states. A total of 15,633 ALS cases were geocoded and were distributed throughout all 50 states. Of these, 62.6% were male, 77.9% were white, and 76.2% were 50–79 years old. For overall case-to-MDC proximity, nearly half (44.9%) of all geocoded cases in the US lived >50 miles from an MDC, including approximately a quarter who lived >100 miles from an MDC. There was a statistically significant difference between distance to MDC by race and age group. Conclusions The high percentage of those living more than 50 miles from the nearest specialized clinic underscores one of the many challenges of ALS. Having better access to care, whether at MDCs or through other modalities, is likely key to increasing survivability and obtaining appropriate end-of-life treatment and support for people with ALS.

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“…Once a diagnosis is established, ongoing telehealth care beyond the initial consultation for patients requiring interdisciplinary care is particularly appealing, as it facilitates access to care for persons who may experience progressive disability through the course of their disease. In a survey of 1,441 outpatients seen at the University of Arkansas general neurology clinics, over 52% of patients stated they would be interested in telemedicine appointments for follow‐up care, with higher interest among patients with physical disabilities or geographical barriers (travel > 1 h) …”

Section: Specific Telehealth Applications For Neuromuscular or Musculmentioning

confidence: 99%

“…In a survey of 1,441 outpatients seen at the University of Arkansas general neurology clinics, over 52% of patients stated they would be interested in telemedicine appointments for follow-up care, with higher interest among patients with physical disabilities or geographical barriers (travel > 1 h). 19 ALS. As a progressive and degenerative neuromuscular disorder, ALS presents a unique challenge to the interdisciplinary care team to provide adequate support to manage symptoms and maximize function.…”

Section: Specific Telehealth Applications For Neuromuscular or Musculmentioning

confidence: 99%

Telehealth applications for outpatients with neuromuscular or musculoskeletal disorders

Howard

Kaufman

2018

Muscle and Nerve

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Telehealth describes the provision of medical services remotely through technology, and may enhance patient access to specialty care services. Although teleneurology has expanded widely since the introduction of telestroke in 1999, telehealth services for outpatients with neuromuscular or musculoskeletal disorders are less widespread. In this narrative review, we will describe the current technology, applications, outcomes, and limitations of this dynamically growing field. Evidence for telehealth applications related to neuromuscular diseases, palliative care, specialized multidisciplinary services, and musculoskeletal care are reviewed. With growing demand for specialized services and finite resources, telehealth provides a promising avenue to promote access to high-quality care, decrease the cost and burden of travel for patients, and with the expansion of software to personal computing and mobile devices, offer flexible, low-overhead practice opportunities for clinicians. Providers embarking on careers in telehealth should be aware of current legal restrictions impacting care to minimize risk and avoid liability. Muscle Nerve 58: 475-485, 2018.

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Telemedicine Interest for Routine Follow-Up Care Among Neurology Patients in Arkansas

Cited by 23 publications

References 42 publications

Teleneurology clinics for polyneuropathy: a pilot study

Teleneurology clinics for polyneuropathy: a pilot study

A spatial analysis of amyotrophic lateral sclerosis (ALS) cases in the United States and their proximity to multidisciplinary ALS clinics, 2013

Telehealth applications for outpatients with neuromuscular or musculoskeletal disorders

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