Experience with telemedicine in a multi-disciplinary ALS clinic

Rijn, Marc van de; Paganoni, Sabrina; Levine‐Weinberg, Mark; Campbell, Katharine; Ellrodt, Amy Swartz; Estrada, Juan; Cohen, Adam B.; Schwamm, Lee H; Berry, James

doi:10.1080/21678421.2017.1392577

Cited by 40 publications

(43 citation statements)

References 23 publications

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“…For patients requiring a longer discussion with the palliative care specialist, we are piloting the option of a palliative care video televisit on a separate date. This has been successfully utilized at our center and others as a means of maintaining care continuity …”

Section: Discussionmentioning

confidence: 99%

Integration of a palliative care specialist in an amyotrophic lateral sclerosis clinic: Observations from one center

et al. 2019

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Palliative care specialists can aid in the care of patients with amyotrophic lateral sclerosis (ALS). In this article, we describe our 1‐year experience incorporating a palliative care specialist into the ALS multidisciplinary team. We describe our integration model, patient selection, and visit content. Of 500 total clinic patients, 74 (14.8%) were seen by the palliative care specialist in 1 year. Referral was most often triggered by advance care planning needs (91%). In the initial visit with the palliative care specialist, topics most frequently covered included goals of care (84%), anxiety/depression (35%), and medical decision‐making about feeding tubes (27%) or tracheostomy (31%). Symptom management comprised a relatively small number of the visits, and duration of visits was limited by patient fatigue. Patients with complex goals of care may benefit from the input of a palliative care specialist, and unique integration models may help to facilitate care delivery. Muscle Nerve 60: 137–140, 2019

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Section: Discussionmentioning

confidence: 99%

Integration of a palliative care specialist in an amyotrophic lateral sclerosis clinic: Observations from one center

et al. 2019

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“…20 A recent retrospective study of 136 telehealth visits for 97 persons with ALS found the most commonly covered topics in ALS telehealth visits included medication management, goals of care, research, and equipment. 21 Remote monitoring of noninvasive and invasive ventilator compliance and parameters has been described 22,23 ; this has become more realistic as commonly prescribed equipment often has the ability to store data on a card that can be mailed or can be uploaded electronically to the monitoring clinic. Telehealth monitoring of pulmonary hygiene training and follow-up in this population has also been described.…”

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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“…Costs for each type of visit were adjusted for medical usefulness (MU), which was rated by the ALS providers and people with ALS for in‐clinic and televisits. To help guide our base‐case assumptions, we used data from the MGH Telehealth for People with ALS (TelePALS) program . In brief, visits are conducted by ALS physicians at MGH using a secure, encrypted Health Insurance Portability and Accountability Act (HIPAA)‐compliant videoconferencing software application (Vidyo, Inc., Hackensack, NJ) to connect directly with ALS patients in their homes using a patient's home computer, tablet, or smartphone (iOS or Android compatible).…”

Section: Methodsmentioning

confidence: 99%

“…A few groups have reported on the use of various forms of telemedicine to provide care to people with ALS, and telemedicine is viewed favorably by both people with ALS and ALS health care providers . We recently reported on our experience implementing a video televisit program to care for people with ALS seen at the Massachusetts General Hospital (MGH) multidisciplinary ALS clinic . Our adoption of video televisits in the ALS patient population was supported by a grant from the ALS Association, philanthropy, and the adoption of an internal hospital program to support physicians using telemedicine.…”

mentioning

confidence: 99%

“…13,15 We recently reported on our experience implementing a video televisit program to care for people with ALS seen at the Massachusetts General Hospital (MGH) multidisciplinary ALS clinic. 16 Our adoption of video televisits in the ALS patient population was supported by a grant from the ALS Association, philanthropy, and the adoption of an internal hospital program to support physicians using telemedicine. More broadly, such resources are not available, resulting in substantial interest, but slow uptake of video televisits for people with ALS nationally despite a warm reception for televisits in ALS and a growing literature demonstrating the cost-effectiveness of telemedicine for outpatient care.…”

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confidence: 99%

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

et al. 2019

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Introduction: We previously reported our amyotrophic lateral sclerosis (ALS) video televisit experience. Here we report on video televisit versus in‐clinic costs, adjusting for perceived medical usefulness (MU). Methods: We take the patient‐perspective and a focused institutional‐perspective. Costs are adjusted for patient/caregiver and physician perceptions of visit MU. The base‐case reflects our outpatient ALS practice. Results: In the base‐case, from the patient perspective, in‐clinic visits cost $1,116 and video televisits cost $89 ($119 after MU‐adjustment). From the institutional perspective, clinic visits cost $799, and video televisits cost $354 ($472 after MU‐adjustment). Adjusted cost‐savings per televisit are $997 (patient) and $327 (institution). Sensitivity analyses on 5 variables accounted for uncertainty in base‐case assumptions. Conclusions: Video televisits provide marked adjusted cost‐savings for patients and institutions. Adjusted costs are sensitive to perceived MU of video televisits. Future research should explore the ability of video televisits to reduce healthcare resource usage. Muscle Nerve 60: 147–154, 2019

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Experience with telemedicine in a multi-disciplinary ALS clinic

Abstract: Video televisits are feasible and can be a useful tool to supplement traditional clinic-based multidisciplinary ALS care.

Cited by 40 publications

References 23 publications

Integration of a palliative care specialist in an amyotrophic lateral sclerosis clinic: Observations from one center

Integration of a palliative care specialist in an amyotrophic lateral sclerosis clinic: Observations from one center

Telehealth applications for outpatients with neuromuscular or musculoskeletal disorders

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

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