Contributions
Abstract: P369
Type: Poster
Abstract Category: Clinical aspects of MS - Economic burden
Background: Telemedicine, the provision of healthcare using an audio-visual connection, is increasingly used to enhance access to medical care for patients with geographic or mobility limitations. The virtual house call--conducting a clinical visit remotely with a patient located at home--has been used successfully in other neurologic disorders but has not been systematically assessed in multiple sclerosis (MS) patients.
Goals:
1) Assess feasibility and satisfaction of virtual house calls for MS patients.
2) Determine differences in cost and visit duration between telemedicine and in-person visits.
Methods: MS patients of a university-affiliated clinic were recruited to participate in two follow-up visits with their treating neurologists, at three and six months after the baseline visit. Randomisation determined which type of visit occurred first for each subject (MS clinic versus virtual house call). Subjects completed surveys providing demographics, MS-related information and opinions on both types of clinical encounter. Feasibility was determined using the percentage of each visit type completed within the scheduled time window. Key questions on subject-completed surveys were used to determine subject"s satisfaction, time spent, and costs.
Results: 42 subjects were randomised, 37 of whom completed both the in-person and virtual house call visits. Twenty-five of the 37 (67.6%) telemedicine visits were completed within the specified time frame as compared with 28 of the 38 (73.7%) in-person visits (difference 6.1%, p=0.75). Nearly all subjects (97.1%) reported that they would recommend virtual house call visits to a peer, similar to 97.4% of subjects who would recommend an in-person visit. A telemedicine visit saved subjects an average of $55 as compared with an in-person visit. An in-person visit required an average of 92 minutes longer to complete compared with a telemedicine visit while a significantly greater percentage of the telemedicine visit was spent with the physician (79.0% vs 25.7%, p< 0.01). Subjects" unscripted survey comments expressed satisfaction with the virtual house calls, with frequently mentioned themes of convenience and equivalence with in-person visits.
Conclusions: This study demonstrates that virtual house calls are feasible and well-liked by a sample of MS patients. The cost effectiveness and time-savings make this form of telemedicine an attractive method for increasing access to neurologic care for MS patients.
Disclosure:
Dr. Robb: nothing to disclose
Dr. Hyland´s employer, the University of Rochester, received research support from Novartis and Chugai.
Dr. Goodman received personal compensation for consulting from the following commercial entities: Abbvie, Acorda Therapeutics, Atara, Bayer, Biogen Idec, Genentech, Sanofi Genzyme, Novartis, Purdue, Teva; Dr. Goodman´s employer, the University of Rochester, received research support for conducting clinical trials from the following commercial entities: Acorda Therapeutics, Avanir, Biogen-Idec, EMD-Serono, Novartis, Ono, Roche, Sanofi Genzyme, Sun Pharma, Teva.
Abstract: P369
Type: Poster
Abstract Category: Clinical aspects of MS - Economic burden
Background: Telemedicine, the provision of healthcare using an audio-visual connection, is increasingly used to enhance access to medical care for patients with geographic or mobility limitations. The virtual house call--conducting a clinical visit remotely with a patient located at home--has been used successfully in other neurologic disorders but has not been systematically assessed in multiple sclerosis (MS) patients.
Goals:
1) Assess feasibility and satisfaction of virtual house calls for MS patients.
2) Determine differences in cost and visit duration between telemedicine and in-person visits.
Methods: MS patients of a university-affiliated clinic were recruited to participate in two follow-up visits with their treating neurologists, at three and six months after the baseline visit. Randomisation determined which type of visit occurred first for each subject (MS clinic versus virtual house call). Subjects completed surveys providing demographics, MS-related information and opinions on both types of clinical encounter. Feasibility was determined using the percentage of each visit type completed within the scheduled time window. Key questions on subject-completed surveys were used to determine subject"s satisfaction, time spent, and costs.
Results: 42 subjects were randomised, 37 of whom completed both the in-person and virtual house call visits. Twenty-five of the 37 (67.6%) telemedicine visits were completed within the specified time frame as compared with 28 of the 38 (73.7%) in-person visits (difference 6.1%, p=0.75). Nearly all subjects (97.1%) reported that they would recommend virtual house call visits to a peer, similar to 97.4% of subjects who would recommend an in-person visit. A telemedicine visit saved subjects an average of $55 as compared with an in-person visit. An in-person visit required an average of 92 minutes longer to complete compared with a telemedicine visit while a significantly greater percentage of the telemedicine visit was spent with the physician (79.0% vs 25.7%, p< 0.01). Subjects" unscripted survey comments expressed satisfaction with the virtual house calls, with frequently mentioned themes of convenience and equivalence with in-person visits.
Conclusions: This study demonstrates that virtual house calls are feasible and well-liked by a sample of MS patients. The cost effectiveness and time-savings make this form of telemedicine an attractive method for increasing access to neurologic care for MS patients.
Disclosure:
Dr. Robb: nothing to disclose
Dr. Hyland´s employer, the University of Rochester, received research support from Novartis and Chugai.
Dr. Goodman received personal compensation for consulting from the following commercial entities: Abbvie, Acorda Therapeutics, Atara, Bayer, Biogen Idec, Genentech, Sanofi Genzyme, Novartis, Purdue, Teva; Dr. Goodman´s employer, the University of Rochester, received research support for conducting clinical trials from the following commercial entities: Acorda Therapeutics, Avanir, Biogen-Idec, EMD-Serono, Novartis, Ono, Roche, Sanofi Genzyme, Sun Pharma, Teva.