Remember the stories your grandparents told about the kindly doctor and his black bag making a house call? Telemedicine is the 21st Century’s version – a virtual house call. Doctors and patients can use technology to communicate through two-way video via smartphones, tablets, or computers. It allows doctors to reach patients they might otherwise not be able to see or provide care for, in a comfortable and convenient way. Telemedicine can be used in rural primary medicine or to bring specialists to people who live too far away from care centers or are unable to travel.
Telemedicine can be useful in treating Parkinson’s disease (PD) by increasing access to neurologists who specialize in movement disorders. Those experts can virtually come into the homes of a wide variety of people, or “see” them in nearby clinics.
Studies show remote care works
Research on telemedicine demonstrates that bringing “remote neurologic care into the homes of people with Parkinson disease (PD) is feasible, beneficial, and valuable.”1 The project findings described significant participant interest in access to telemedicine. Published in the Journal of Neurology by Dr. Ray Dorsey of the University of Rochester, they suggest that telemedicine appointments are just as effective as those that were face to face in an office.2
Telemedicine as part of the PD treatment plan
Even though Parkinson’s is a neurological condition, 40% of people with PD never see a neurologist. Telemedicine can change that. More resources could be available through a variety of medical networks and people could access neurologists and other specialists using virtual communications tools.
Telemedicine has several components including teleconsultation, telementoring, and telemonitoring. This discussion has been about the teleconsultation component of telemedicine, a paradigm shifting virtual doctor/patient visit.3
Telemedicine as teaching tool
Telementoring uses technology to enable physicians to mentor other physicians. For example, a primary care physician treating Parkinson’s patients may be able to get guidance, even during a patient consultation, from a neurologist or a neuropsychologist regarding improving therapeutic outcomes. Some communities could be hundreds of miles from the nearest specialists. Using a live video conference to access experts could improve the local quality of care delivered.
Telemonitoring plays a lesser role in treating PD. It uses medical devices to remotely capture physiological data that is then transmitted, generally by telephone or internet, to a health care facility. Examples include capturing cardiac or sleep data.
Insurance still catching up with technology
Insurance coverage for telemedicine is not universal. Neither private insurance nor Medicaid and Medicare routinely pay these virtual consultations. Health insurance companies will need to review the cost benefit analysis of providing access to care with improving outcomes to determine an appropriate reimbursement methodology. These business model changes take time just as the technology takes time to develop.
Tech challenges and opportunity
What has to be done to make telemedicine a routine part of the medical future? Advances in medicine and technology change quickly but adapting them to routine use takes time. Researchers will continue to study accessibility, satisfaction, and medical outcomes for people with Parkinson’s as well as other conditions. Telemedicine is subject to the same HIPPA regulations as in-office medical visits. Patient records must be kept confidential. Risk assessments of data transmission will need to be addressed. Information security, increasing the numbers of participating physicians, and medical centers home access will all play a role in how these programs expand.
Telemedicine has the potential to bring care to people with Parkinson’s who are severely debilitated, whether physically or psychologically, and to those who are just too far away to get the specialty care they need. Virtual house calls could be routine for your grandchildren.
Beck, C., Beran, D. National randomized controlled trial of virtual house calls for Parkinson disease. Neurology, the Journal of the American Academy of Neurology. Published August 16, 2017 http://www.neurology.org/content/89/11/1152. Accessed online October 16, 2017.
Dolhun, R., Cohen, R. Telemedicine to treat Parkinson’s? Michael J. Fox Foundations website. Published September 19, 2017https://www.michaeljfox.org/foundation/news-detail.php?telemedicine-to-treat-parkinson. Accessed online October 16, 2017
Scudder, L., Carter, E. The ABCs of Telemedicine: It's More Than Just Picking Up the Phone. Interview Summary on Medscape website. Published September 25, 2017. https://www.medscape.com/viewarticle/886086?pa=JPLRTbgWSBBs%2FOheCCZySRPRUz6IbuN0fo6aqUYN0KMsj%2FP4v62AmRxK05v5VcAi43mU9jD%2B1DtnxY47OmyybA%3D%3D. Accessed online October 17, 2017