Abstract
Objective: To describe the real-world use of telemedicine-enabled clinical care in a large multiple sclerosis (MS) and Neuroimmunology academic practice and quantify its role in alleviating patient burden.
Background: For individuals with chronic neurological conditions, including MS, medical appointments represent one of the many “hassles of daily life”, with hidden financial and opportunity costs. The UCSF MS Center routinely provides clinic to in-home televideo appointments for established patients using a secure platform.
Design/Methods: Between 1/2017 and 10/2017, 5 participating physicians and their patients were surveyed after consecutive visits (50 televideo and 100 in-person). Summary statistics were calculated.
Results: Overall, patients seen via televideo were older (mean age 51.3 vs. 44.0), more educated (84% vs. 60% completed college), more often White (96% vs. 74%) and less often female (67% vs. 79%, p=<0.01 for all) than patients seen in clinic.
Providers reported satisfaction with their patient evaluation in 96% visits, as well as avoidance of unneccessary testing (8%) or referrals to the emergency room (4%).
Patients participated in televideo visits at home (80%) or at work (20%); 33% avoided taking a day off work, with average round trip distance of 246 kilometers to clinic avoided, as well as overnight lodging (23%) and airfare (11%). In 39% visits, likely travel companions avoided time off work, and in 55% patients avoided arranging care for dependents (children, other). Patients (strongly) agreed that they had achieved their clinical goals for the telemedicine visits (86%/14%). Perceived care between telemedicine and in-clinic visits was similar for 6 of 7 quality measures assessed (exception: eye contact was “extremely good” in 84%, vs. 99%, of visits).
Conclusions: When a part of the care continuum, telemedicine reduces travel costs and caregiver burden, and enables convenient and effective follow-up, with a minor cost to patient perception of care. Outreach is required to access a more diverse population.
Disclosure: Dr Bove has nothing to disclose. Dr. Garcha has nothing to disclose. Dr. Bevan has nothing to disclose. Dr. Crabtree-Hartman has received research support from has received educational grants from the MS Foundation, Teva neurosciences, and Biogen. She has served as a consultant to Genzyme, Teva and Novartis. She is on the Speakers Bureau for Genzyme, Teva and Biogen. Dr. Green has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Dr. Green has received personal compensation for activities with Inception Sciences, Mylan Pharma, Medimmune, and Bionure. Dr. Green has received personal compensation in an editorial capacity for Dr. Green has received personal compensation for serving on the board of Inception Sciences. Dr. Green has received research support from Dr. Green has received research support from Inception Sciences, Biogen, and Novartis. Dr. Gelfand has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with .
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