Telemedicine for Parkinson's Disease: Limited Engagement Between Local Clinicians and Remote Specialists

Elson, Molly J.; Stevenson, E. Anna; Feldman, Blake; Lim, Jeong-Ok; Beck, Christopher A.; Beran, Denise B.; Schmidt, Péter; Biglan, Kevin; Simone, Richard; Willis, Allison W.; Dorsey, E. Ray; Boyd, Cynthia M.

doi:10.1089/tmj.2017.0210

Cited by 18 publications

(16 citation statements)

References 7 publications

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“…In our study, all the patients included completed satisfactorily the online evaluation. Elson et al reported that the greatest perceived barrier for patients with PD was distance from patient to specialist. Moreover, 40% of local clinicians would recommend video visits to facilitate communication between remote specialists and local clinicians .…”

Section: Discussionmentioning

confidence: 99%

“…Elson et al reported that the greatest perceived barrier for patients with PD was distance from patient to specialist. Moreover, 40% of local clinicians would recommend video visits to facilitate communication between remote specialists and local clinicians . A high interrater reliability was found for all online measurements carried out in this study (ρ = 0.769‐1).…”

Section: Discussionmentioning

confidence: 99%

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Agreement Between Face‐to‐Face and Tele‐assessment of Upper Limb Functioning in Patients with Parkinson Disease

Cabrera‐Martos

Ortíz‐Rubio

Torres‐Sánchez

et al. 2019

PM&R

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Background: Upper limb disturbances are prevalent in patients with Parkinson disease (PD) and can limit their participation in activities of daily living. Tele-assessment of upper limb motor symptoms using an Internet application may be an alternative for addressing the growing demand for monitoring of disease progression. Objective: To evaluate the level of agreement between face-to-face and tele-assessment of patients with PD. Design: Reliability study. Setting: Parkinson's Disease Association. Participants: Twenty-one patients with PD from a local association participated in the study. Methods: Patients attended a session for clinical face-to-face and real-time online tele-assessment. Main Outcome Measurements: Upper limb measures of function (assessed with the Manual Ability Measure 16), dexterity (evaluated using the coin rotation task), motor speed (assessed by the finger tapping test), tremor (evaluated with the Fahn-Tolosa-Marin Tremor Rating Scale), and range of motion (using the Kinovea software) were recorded by two independent researchers. Results: All the outcome measures evaluated showed a good interrater, intraclass correlation coefficient (ρ > 0.75). In addition, most confidence intervals were narrow and excluded 0.8. The lowest reliability was obtained for elbow flexion of the most affected upper limb (ρ = 0.75; confidence interval 0.49-0.89) and the highest reliability for finger tapping tests (ρ = 1; 1, 1). Conclusions: This study demonstrates high interrater reliability of upper limb tele-assessment in patients with PD compared to a face-to-face assessment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Agreement Between Face‐to‐Face and Tele‐assessment of Upper Limb Functioning in Patients with Parkinson Disease

Cabrera‐Martos

Ortíz‐Rubio

Torres‐Sánchez

et al. 2019

PM&R

View full text Add to dashboard Cite

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“…Thus, tele-neurology can exist as a local hub or facility that is connected electronically to a larger hospital, neurologist, or specialist to provide consultation. The audio-visual conferencing equipment often consists of a camera with pan, tilt, and zoom capabilities so that the neurologist or specialist can examine and speak to the patient [11]. Other sorts of devices used to evaluate patients remotely include using robotic telepresence (RTP) in which a robotic audiovisual platform can move around to create a sense of “being present” at the remote site [12].…”

Section: Reviewmentioning

confidence: 99%

“…Despite the barriers some patients face in accessing traditional face-to-face neurology care such as traveling large distances or having a disability, in a survey of local physicians of Parkinson’s patients, many were ambivalent about recommending tele-health visits for their patients. Many also reported not receiving recommendations of care from the tele-neurologist, but of those who did, they implemented some or all of their recommendations and found them to be beneficial [11]. Despite this, tele-neurology is still growing; in a survey to neurology departments around the United States, tele-neurology is being applied, by way of consultations, for acute stroke, movement disorders, neurocritical care, and chronic care [27].…”

Section: Reviewmentioning

confidence: 99%

“…For instance, Parkinson’s disease is a chronic condition that benefits from specialist care although 40% of Medicare beneficiaries with Parkinson’s do not see a neurologist [11]; a study showed that telemedicine could be effective in the chronic phase of neurological illness as patients with Parkinson’s showed improved outcomes in quality of life and motor performance via telemedicine. Similarly, virtual rehab devices with two-way communication to remotely sense paretic limb activity and provide active input to the limb are available [14].…”

Section: Reviewmentioning

confidence: 99%

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Multidisciplinary Approach and Outcomes of Tele-neurology: A Review

Patel¹,

Malik²,

DeMasi³

et al. 2019

Cureus

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In rural and underserved areas, there are restrictions in healthcare due to the lack of availability of neurologists; patients have to travel long distances to receive the required care. Considering the fact that neurological conditions have large mortality and disability rates, there is a need for innovative services like tele-neurology. It is an important tool in improving the health and quality of life by using different ways of communication between neurologists and patients, or neurologists and other providers. We examine the current types of facilities available in tele-neurology, as well as outcomes, barriers, limitations, legal litigations, and the multidisciplinary nature based on prior studies. We have also suggested recommendations for the future of tele-neurology including effective-accessibility and inexpensive-utilization in developing countries. There are various tele-health programs created by The Veterans Health Administration including a clinical video tele-health (CVT) system. This system allows direct patient care of veterans by neurologists. The University of South Carolina implemented a web-based tele-stroke program in which acute ischemic stroke patients were treated in the Emergency Department (ED) of rural hospitals by neurologists, after consulting with rural ED physicians. With growing technology and popularity of tele-neurology, there are now international collaborative efforts in tele-medicine that are looking to be adapted to tele-neurology. Thus, tele-neurology can provide quality neurological care with patient satisfaction, as well as time and cost savings. The tele-stroke group established by TRUST-tPA trial (Therapeutic Trial Evaluating Efficacy of Telemedicine (TELESTROKE) of Patients With Acute Stroke) has 10 community hospital-emergency rooms that were connected to a stroke center. It was found that tele-stroke is appropriate in places where there is no way for a patient to access a stroke unit within a 4.5-hour time window. Like other tele-neurology subtypes, tele-epilepsy and pediatric tele-neurology also offer more follow-up care to people of remote areas which have limited access. There are other subtypes like mental health, chronic neurological care, and hospitalist which are very effective in improving outcome and quality of life of people living in remote areas. Tele-neurology has effectively reduced travel costs and times; there is high patient satisfaction and reduced disparity for general and specialized neurological care. But there are certain limitations like large equipment costs, certain bandwidth requirement, and trained staff to use the equipment. Transmission of patient information using public internet raises the concern of legality. There should be sufficient encryption to satisfy the Health Insurance Portability and Accountability Act (HIPAA) requirements to ensure patient confidentiality and safety of personal data. The adaptation of tele-neurology is a powerful and innovative way to enhance healthcare in areas with a shortage o...

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Diabetes care in the time of COVID‐19: video consultation as a means of diabetes management

2022

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Background: This review specifically focuses on the use of video consultation in diabetes management, in comparison to standard care. The population of chronic condition sufferers in the UK is considerable and teleconsultation use has, in recent years, been explored. COVID‐19 has created an additional pressure on health services to use teleconsultation. Diabetes mellitus affects approximately four million people in the UK. If clinical outcomes are uncompromised, the benefits of using a remote service could encourage the use of video consultation for diabetes management in normal practice. Aims: A systematic review of the use of video consultation in place of standard consultation in the management of diabetes mellitus. Both clinical and non‐clinical outcomes are reviewed, in addition to patient satisfaction levels after using video consultation. Methods: A systematic literature search was conducted to select published articles from web‐based health databases. Data extraction and analysis of results followed. Results: Twelve studies were selected. Overall, the clinical outcomes (HbA 1c , low‐density lipoprotein levels and blood pressure) appeared to be uncompromised with the use of video consultation. Patient satisfaction was high, with few limitations found. The economic and time saving benefits of this approach proved to be additional advantages. Conclusions: Despite there being a lack of literature identified in this field, the results support the use of video consultation in diabetes management. The evidence suggests that this approach should be utilised in the time of COVID‐19 and beyond. Future research should assess the use of video consultation over a reasonable duration through randomised controlled trials. Copyright © 2022 John Wiley & Sons.

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Telemedicine for Parkinson's Disease: Limited Engagement Between Local Clinicians and Remote Specialists

Abstract: The greatest perceived barrier among respondents was distance from patient to specialist, and 40% of local clinicians would recommend video visits. As telemedicine grows, improved communication between remote specialists and local clinicians is likely needed.

Cited by 18 publications

References 7 publications

Agreement Between Face‐to‐Face and Tele‐assessment of Upper Limb Functioning in Patients with Parkinson Disease

Agreement Between Face‐to‐Face and Tele‐assessment of Upper Limb Functioning in Patients with Parkinson Disease

Multidisciplinary Approach and Outcomes of Tele-neurology: A Review

Diabetes care in the time of COVID‐19: video consultation as a means of diabetes management

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