New regulations issued by the Department of Veterans Affairs (VA) increase access to telemedicine for veterans who get care through the VA health system. Telemedicine provides physician consultations using electronic video communications over the Internet either by computer, tablet, or smartphone.1
Over 80,000 veterans in the US have Parkinson’s disease (PD). Using telemedicine, two-way video can revolutionize the way people seek convenient, accessible health care using technology.2
Parkinson’s is long-term
Parkinson’s is chronic condition that requires long-term medical management. It is a neurodegenerative disorder that affects motor, non-motor, and cognitive functions.
With no known cause or cure, Parkinson’s, which generally has an onset after age 60, affects an aging population including increasing numbers of vets. Access to care is a concern to all in the health care system and particularly to veterans who rely on care through available services in the VA health system. Telemedicine, originally developed to make care accessible to people in remote locations, now offers increased access to PD specialists and case managers.
Caring for people with Parkinson’s generally involves a care team that may include a primary care physician, neurologist, movement disorder specialist, and allied health specialists like physical, speech and occupational therapists, mental health counselors and nutritionists.
Yet some of these services may not be readily available in many communities. Telemedicine offers access to an array of services without regard to patients’ location.3
Access to care
Access to care for some is limited by geography, physical or financial ability to travel, wait time and other obstacles. This can be a significant barrier to PD care management.3
The VA’s telemedicine program, under the new regulations, can now provide services across state lines. This is an access breakthrough. As long as each veteran has the required technology to support video conferencing, and the ability to operate the equipment either independently or with the help of a caregiver or other provider they can be seen remotely.4
A telemedicine visit is not that different from an in-person visit as far as the length of time and interview portions, and it generally includes a modified physical exam. Certain aspects of a neurological exam cannot be done remotely, but a modified version of the Unified Parkinson’s Disease Rating Scale (UPDRS) is used to assess patient conditions on a related scale of evaluation as in a doctors office.3
Telemedicine allows for case management and the opportunity to create a personal connection says Catherine Buck, National Home Telehealth Lead and Clinical Nurse Analyst.2 Evaluation of remote care provided via technology has yielded similar clinical outcomes and improved participant compliance.3
Clinical studies and patient surveys have found that most people using telemedicine have a high level of satisfaction with the process. Positive comments reflect convenience, reduced travel time and lower associated expense. Fewer telehealth appointments are cancelled than traditional medical office visits. This may result in improved clinical results and more efficient use of the health care system.3
Future advances in technology will continue to increase access to care. For veterans and others with Parkinson’s, it will be important to evaluate benefits as well as the limitations associated with virtual medicine and the remote delivery of care.3
Katz,S. Policymakers Expand Telemedicine Services for Veterans. Published May 24, 2018. www.michaeljfox.org/foundation/news-detail.php?policymakers-expand-telemedicine-services-for-veterans. Accessed online August 1, 2018.
Thomas, M. Telehealth Revolutionizing Veterans Health Care. US Department of Veterans Affairs website. Published January 23, 2018. https://www.va.gov/health/newsfeatures/2018/january/telehealth_revolutionizing_veterans_health_care.asp. Accessed online August 2, 2018.
Wilkinson JR, Spindler M, Wood SM, et al. High patient satisfaction with telehealth in Parkinson disease: A randomized controlled study. Neurol Clin Pract. 2016;6(3):241-251. Published June 2016. www.ncbi.nlm.nih.gov/pmc/articles/PMC4909521/. Accessed online August 1, 2018.
VA Expands Telehealth by Allowing Health Care Providers to Treat Patients Across State Lines. US Department of Veterans Affairs website. Published May 11, 2018. www.va.gov/opa/pressrel/pressrelease.cfm?id=4054. Accessed online August 1, 2018.