Current perspectives on the role of telemedicine in the management of Parkinson’s disease

Joel L Eisenberg,1,2 Jyhgong Gabriel Hou,1,2 Peter J Barbour1,2 1Department of Neurology, Lehigh Valley Health Network, Allentown, PA, USA; 2Morsani College of Medicine, University of South Florida, Tampa, FL, USA Abstract: Parkinson’s disease (PD) is a progressive neurological disorder that primarily affects older adults. The number of patients who receive specialty care continues to be limited, even though the benefits of seeing a movement disorder specialist for management of PD have been well established. Telemedicine has been suggested as a useful tool in addressing the problem of access to specialty care. As evidenced by the literature, it has been suggested that using telemedicine to treat PD is feasible and economically advantageous for both patients and providers. A high level of interest exists on both sides, and a high level of patient and provider satisfaction has been reported. The quality of care provided to patients with PD via telemedicine is comparable to in-person care based on objective measures. Additionally, telemedicine can increase access to care for certain patient populations. The current shortcomings of telemedicine that limit widespread use of the technology include technological barriers, limitations of the virtual exam, limited patient access to technology, weaknesses of current research, ongoing difficulties negotiating reimbursement for virtual visits, and licensing difficulties. We propose an ideal telemedicine system for PD set up as a remote clinic to ensure consistency across patient encounters. This clinic would have adequate support staff to conduct the physical exam, organize patient scheduling and discharge instructions, and coordinate ancillary services for patients including physical therapy, occupational therapy, psychological services, speech and language therapy, and social services. The future of telemedicine for the treatment of PD is promising, but broader research is needed to understand the challenges of patients living with PD. New portable technologies for monitoring symptoms and delivering treatment will continue to change the landscape, but it will still be some time before these technologies can be streamlined into virtual care without the need for in-person assessments and adjustments. Keywords: movement disorders, video conferencing, access to care, neurology, nursing home, home healthcar