PARKINSON’S DISEASE Treated via the Computer
How would you like to have your next visit with your PARKINSON’S neurologist in the privacy of your own home? What if you didn’t have to travel to the office and could still have the benefit of an office visit? Or if you were able to have the benefit of consulting a specialist who may be too far away to actually visit in person? It may be coming sooner rather than later.
Allison Willis, M.D. did a chart review of 138,000 people diagnosed with PARKINSON’S DISEASE and was alarmed to find that more than 40% of them never had the benefit of seeing a movement disorder specialist. She also found that 40% of them who did have the benefit of a neurologist had a 22% reduced risk of death and a 21% reduced risk of entering nursing home care. And only about 8% of the people with PARKINSON’S ever saw a movement disorder trained neurologist.
Peter Schmidt, Ph.D., has a degree in biomedical engineering. He was challenged by the numbers in Dr. Willis’ study and thought there must be a better way to connect patients with trained neurologists. So he worked out the technical issues between the math and medicine. Ray Dorsey, M.D. is a movement disorder trained neurologist at the University of Rochester Medical Center. Previously, he and another neurologist had developed and piloted a telemedicine program of PARKINSON’S patients in a nursing home. The next challenge was taking the telemedicine program to other people with PARKINSON’S DISEASE. He used a $50,000 grant from Verizon and was able to consult via high speed internet connection with patients in their homes.
Working together with Dr. Schmidt and other colleagues, they were able to write a proposal that would allow them to connect with about 200 patients in their homes. They received a $1.7 million dollar grant and since May of this year has been able to provide telemedicine care to about 100 people and hope to expand that to 200 people. The project has so far covered only 5 states, and provides a one time telemedicine consultation for free. Considering that there are few PARKINSON’S specialists spread far and wide and many, many people with PARKINSON’S, this may prove to be a much better way to provide people with the benefits of a specialist’s knowledge and use the doctors’ clinical skills more effectively. It may not be quite as good as a visit in person, but it is better than no visit to a specialist at all. The future will surely see many technological improvements. Dr. Dorsey’s vision is that “anyone with PARKINSON’S, anywhere can get the care they need.”
Vinayak Venkataraman, Sean J. Donohue, Kevin M. Biglan, Paul Wicks, E. Ray Dorsey. Virtual visits for Parkinson disease. Neurology: Clinical Practice, December 2013
Wilis, A>W>, Schootman, M., Evanoff, BA, et al. Neurolgist care in Parkinson disease. Neurology, 2011; 77:851-857
Review by Marcia McCall