[P2.048] Telehealth in the Parkinson's Disease Subspecialty Clinic: The Key to the Patient-Centered Medical Home
Meredith Spindler,1Eileen Hummel,1Stephanie Pawlowski,2Daniel Weintraub,1Steven Marcus,2Margaret Stineman,2James Morley,1John Duda,1Jayne Wilkinson1
1Philadelphia, PA, USA, 2
OBJECTIVE: Determine the feasibility, patient satisfaction, cost and clinical outcomes of using telehealth in Parkinson's disease (PD).
BACKGROUND: PD is a complex neurodegenerative disorder that benefits from a multidisciplinary approach to comprehensive, subspecialty care as embodied in the Patient-Centered Medical Home (PCMH) model. Telehealth is an innovative resource that can enhance care within this framework by increasing access and reducing travel-related costs. Research suggests that these implementations lead to increased patient satisfaction, cost savings and equal or better clinical outcomes, but they have not been well-studied in PD.
DESIGN/METHODS: Randomized-controlled trial. Video telehealth took place at a VA facility nearer to the patient ("outreach telehealth") or in the patient's home ("home telehealth"). The control group received usual, in-office care. Patient satisfaction, assessed at 6 and 12 month visits by quantitative questionnaires and qualitative interviews, was the primary outcome. Secondary outcomes included measures of quality of life (PDQ-8), depression, travel cost, and clinical events (ED visits, admissions, provider phone contacts, and clinical referrals). T-test and chi-square analyses will examine quantitative differences between groups. Qualitative analysis of post-telehealth patient interviews will be conducted. Data collection will conclude in January 2014.
RESULTS: 86 male patients were enrolled (home telehealth:18 active, 18 control; outreach telehealth:26 active, 24 control) with a mean age of 73 (Range: 42-87). There were no significant differences between baseline characteristics of active and controls in each arm (p>0.05). 38% of PD patients in our clinic were eligible; with 62% of these enrolling. 43 patients have completed the 12 month study, 11 died before completion and 11 withdrew.
CONCLUSIONS: The feasibility of studying telehealth for PD in a PCMH model has been demonstrated. As telehealth programs expand, it will be important to define their role in PD, and these findings will represent the largest study to date on this important topic.
Study Supported by: Veterans Affairs Medical Center, VISN 4 Center for Evaluation of Patient-Aligned Care Teams (CEPACT)
Category - Movement Disorders: Parkinson's Disease
Tuesday, April 29, 2014 7:30 AM
P2: Poster Session II: Movement Disorders: Co-morbidities and Novel Care Models (7:30 AM-11:00 AM)