Adjusted cost analysis of video televisits for the care of people with amyotrophic lateral sclerosis

Paganoni, Sabrina; Rijn, Marc van de; Drake, Kristin; Burke, Katherine; Doyle, Michael W.; Ellrodt, Amy Swartz; Nicholson, Katherine L.; Atassi, Nazem; Marchi, Fabiola De; Babu, Suma; Estrada, Juan; Schwamm, Lee H; Berry, James

doi:10.1002/mus.26606

Cited by 27 publications

(22 citation statements)

References 21 publications

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“…If patients lived closer to the institution than in the original model, savings were less, but there were still savings by using telehealth visits. The study concluded that telehealth visits provide marked adjusted cost savings for both patients and institutions under a variety of assumptions …”

Section: Synchronous Telehealth In Alsmentioning

confidence: 99%

The Use of Telehealth to Enhance Care in ALS and other Neuromuscular Disorders

et al. 2020

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Telehealth has the potential to improve the efficiency of healthcare while reducing the burden on patients and caregivers. Encounters can be synchronous or asynchronous. When used for care of those with amyotrophic lateral sclerosis (ALS) by individual health care providers or by a multidisciplinary team, synchronous telehealth is feasible, acceptable, may produce outcomes comparable to those of in-person care, and is cost effective. Individuals with ALS who use telehealth tend to have lower physical and respiratory function and to live farther from an ALS clinic than those who exclusively attend in-person clinic visits. Asynchronous telehealth can be used as a substitute full multidisciplinary visits, or for remote monitoring of pulmonary function, gait/falls, and speech. Barriers to implementing telehealth on a wider scale include disparities in access to technology and challenges surrounding medical licensure and billing, but these are being addressed. K E Y W O R D S ALS, mHealth, mobile health, telehealth, telemedicine 1 | INTRODUCTION TO TELEMEDICINE AND TELEHEALTH Today's healthcare landscape contains many references to, and examples of, telemedicine and telehealth. Sometimes, these terms are used interchangeably. Generally, telemedicine is defined as a remote interaction between a clinician and a patient. This is the traditional way most people think of telemedicine. Telehealth is the provision of a broader range of services remotely. 1 For patients with neuromuscular diseases, this can include collection of data on clinical measures such as respiratory function, gait, falls, muscle strength, and the rate and quality of speech.Telehealth encounters can be synchronous or asynchronous. In synchronous encounters, information is transmitted in both directions during the same period of time. These can be binary transmissions between patients or caregivers and healthcare providers, or multiperson encounters with other healthcare providers or family members interacting simultaneously. A live videoconference between a patient, his or her caregiver, and a healthcare provider is an example of synchronous telehealth. Asynchronous encounters, also sometimes called the "store and forward" method, occur when information is collected at one time and then forwarded for review at another time. Examples of this include taking photographs, filming videos, or recording medical data (respiratory, cardiac, gait, etc.) at a location remote from the Abbreviations: AAN, American Academy of Neurology; ALS, amyotrophic lateral sclerosis;

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Section: Synchronous Telehealth In Alsmentioning

confidence: 99%

The Use of Telehealth to Enhance Care in ALS and other Neuromuscular Disorders

et al. 2020

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“…In addition, the telehealth model allows the patients to hold the consultation in familiar environments, making it more comfortable to them, maintaining the link with multidisciplinary units even in more advanced stages (46).…”

Section: Beyond the Hospital Walls Tele-health In Times Of Covid-19mentioning

confidence: 99%

Neuromuscular Diseases Care in the Era of COVID-19

Recasens

Rubio

2020

Front. Neurol.

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The COVID-19 pandemic has pushed health systems to their limit and forced readjustment of standards of care for different pathologies. Management of neuromuscular diseases becomes a challenge since most of them are chronic, disabling, progressive, and/or require immunosuppressive drugs. There are three main aspects of COVID-19 that affect neuromuscular diseases care. The first one relates to how SARS-CoV2 directly affects different neuromuscular pathologies. Respiratory weakness, as seen in myasthenia gravis, amyotrophic lateral sclerosis, and myopathies, and the use of immunomodulatory drugs (Myasthenia Gravis and Chronic Inflammatory Demyelinating Polyneuropathy) make this group of patients potentially more vulnerable. Secondly, safety measures also affect proper care, limiting care continuity, and physical rehabilitation (one of the essential aspects of myopathies treatment). Telemedicine can partially solve the problem allowing for a continuum of close care, avoiding unnecessary visits, and even guaranteeing the attention of professionals from tertiary care centers. However, one of the crucial steps in neuromuscular diseases is diagnosis, and in most scenarios, more than one face-to-face visit is needed. Lastly, the global COVID-19 situation will also have an economic impact on patients and their families. This situation is of particular concern given that neuromuscular diseases already present difficulties due to the scarcity of resources in terms of public healthcare and research.

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“…Multidisciplinary ALS consults have been sparsely done through telemedicine, either by live videoconferences on real-time, synchronous [ [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] ] or though the store-and-forward method, asynchronous [ 25 ]. Videoconferences connect the multidisciplinary ALS teams at the tertiary centres to the patients at home, or to the local community hospitals/ health centres [ 12 , 21 , 22 ].…”

Section: Already Implemented or Ongoing Studies On Emergent Technologmentioning

confidence: 99%

“…However, acute care issues were rarely discussed [ 13 ]. Adjusted cost-savings to medical usefulness of those video tele-visits as compared to in-clinic visits were further addressed [ 14 ], representing, per visit, $997 for the patients (in-clinic visit $1116; video tele-visit adjusted for medical usefulness $119) and $327 for the institution (in-clinic visit $799; video tele-visit adjusted for medical usefulness $472). Patients and providers rated medical usefulness modestly lower for video tele-visits, despite following the American Academy of Neurology Guidelines [ 26 ], as compared to in-clinic visits.…”

Section: Already Implemented or Ongoing Studies On Emergent Technologmentioning

confidence: 99%

New technologies and Amyotrophic Lateral Sclerosis – Which step forward rushed by the COVID-19 pandemic?

Pinto¹,

Quintarelli²,

Silani

2020

Journal of the Neurological Sciences

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Amyotrophic Lateral Sclerosis (ALS) is a fast-progressive neurodegenerative disease leading to progressive physical immobility with usually normal or mild cognitive and/or behavioural involvement. Many patients are relatively young, instructed, sensitive to new technologies, and professionally active when developing the first symptoms. Older patients usually require more time, encouragement, reinforcement and a closer support but, nevertheless, selecting user-friendly devices, provided earlier in the course of the disease, and engaging motivated carers may overcome many technological barriers. ALS may be considered a model for neurodegenerative diseases to further develop and test new technologies. From multidisciplinary teleconsults to telemonitoring of the respiratory function, telemedicine has the potentiality to embrace other fields, including nutrition, physical mobility, and the interaction with the environment. Brain-computer interfaces and eye tracking expanded the field of augmentative and alternative communication in ALS but their potentialities go beyond communication, to cognition and robotics. Virtual reality and different forms of artificial intelligence present further interesting possibilities that deserve to be investigated. COVID-19 pandemic is an unprecedented opportunity to speed up the development and implementation of new technologies in clinical practice, improving the daily living of both ALS patients and carers. The present work reviews the current technologies for ALS patients already in place or being under evaluation with published publications, prompted by the COVID-19 pandemic.

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Adjusted cost analysis of video televisits for the care of people with amyotrophic lateral sclerosis

Cited by 27 publications

References 21 publications

The Use of Telehealth to Enhance Care in ALS and other Neuromuscular Disorders

The Use of Telehealth to Enhance Care in ALS and other Neuromuscular Disorders

Neuromuscular Diseases Care in the Era of COVID-19

New technologies and Amyotrophic Lateral Sclerosis – Which step forward rushed by the COVID-19 pandemic?

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