Experience with telemedicine in a multi-disciplinary ALS clinic

Abstract

Objective: Telemedicine using video televisits is emerging as a means to provide care directly to patients. Here we report our experience using video televisits to provide follow-up care as a part of the Massachusetts General Hospital (MGH) Telemedicine for People with ALS (TelePALS) initiative.

Methods: This was a retrospective chart review of all video televisit encounters conducted by the MGH ALS clinic between September 2014 and January 2016.

Results: A total of 97 distinct ALS patients were seen using video televisits. Twenty-four percent of these patients had more than one video televisit. The median distance of the patients’ primary residence to MGH was 211 miles. The average video televisit lasted 32 min (±12). About half the patients (54%) were ambulatory at the time of their video televisit. The most commonly addressed issues were medication management (89%), discussion of goals of care (74%), research (55%) and equipment use (50%). Acute care issues were rarely discussed.

Conclusion: Video televisits are feasible and can be a useful tool to supplement traditional clinic-based multidisciplinary ALS care.

Keywords:

• Telemedicine
• videoconferencing
• video televisits
• multidisciplinary
• telehealth

Acknowledgments

We would like to thank Merit Cudkowicz, Chair of Neurology at the Massachusetts General Hospital, for her support to the TeleNeurology Program. We would also like to thank the ALS Association for supporting innovation in ALS clinical care and research.

Declaration of interest

Marc van de Rijn: no disclosures.

Mark Levine-Weinberg: no disclosures.

Katie Tee: no disclosures.

Amy Swartz Ellrodt: no disclosures.

Juan Estrada: no disclosures.

Adam Cohen has consulted with Decibel Therapetics and the National Football Association.

Lee Schwamm is the Director of MassGeneral TeleHealth, and a consultant to LifeImage (a teleradiology company).

Sabrina Paganoni has consulted with Roche, and received research support from the NIH (Career Development Award 2K12HD001097-16), Target ALS, the Salah Foundation, the ALS Association, ALS Finding a Cure, Amylyx, and the Spastic Paraplegia Foundation.

James Berry has consulted with Biogen, Denali Therapeutics and Neuraltus Pharmaceuticals, and has received research support from Voyager Therapeutics, GSK, Cytokinetics, Brainstorm Cell Therapeutics, Novartis, ALS Therapy Development Institute, the ALS Association, MDA and NIH.

Additional information

Funding

This study was funded by the ALS Association. (Amyotrophic Lateral Sclerosis Association).