Telemedicine vs Office visits in a Movement Disorder Specialty Clinic: Comparative Satisfaction of physicians and patients. (P4.003)

Objective: Compare patient and physician satisfaction between home-based telemedicine visits and office visits for follow-up care within a movement disorders program. Background: Telemedicine for neurological care includes hospital-, office-, and home-based services. Cost and treatment analyses have been published, but few studies have investigated direct comparison of office-based and home-based patient and physician satisfaction. Design/Methods: Patients from a movement disorders practice were offered telemedicine visits as part of follow-up care if they: 1) enrolled in Epic integrated patient portal; 2) lived 40 miles or more from the office; 3) had home computer access with high-speed internet, camera, microphone, and speakers; 4) agreed to complete post-visit questionnaires comparing their telemedicine visit with their previous office visit. A 10-point Likert Scale (10=most satisfied) was used to assess patient and physician overall and comparative satisfaction with prior office visits. Results: 38 subjects fit distance qualifications, all expressed interest, but 20 lacked adequate home computer equipment. Sixteen of attempted 18 telemedicine visits were successful, with two failed visits due to technical issues. Overall Satisfaction–related items had a median score of 9.5 (range 6–10) and Comparative Satisfaction favored telemedicine (9.5, range 7–10). Average set-up time for patients was 24.6 min (SD 29.2, range 5–90 minutes), compared to an estimated 2 hour commitments involved in round trip travel. Although some assessments could not be performed (postural instability and rigidity in Parkinson’s disease), physicians rated quality-of-service for telemedicine visits as equivalent to office encounters (median score 10, range 6–10). Conclusions: This direct comparison of patient satisfaction with telemedicine vs. office visits strongly favors telemedicine care, patients highlighting convenience, time and expense. Despite some assessment limitations with telemedicine visits, physicians expressed equivalent quality-of-service to in-office visits. As technology simplifies and demand for access increases, telemedicine visits may become a practical means for follow-up movement disorder care with high patient and physician satisfaction. Study Supported by: This work was supported by a pilot program project from Rush University Medical Center. The Rush Parkinson’s Disease and Movement Disorders Program is a Parkinson’s Disease Foundation Parkinson’s Research Center Disclosure: Dr. Hanson has nothing to disclose. Dr. Goetz has received personal compensation for activities with Acadia, Addex, Avanir, Boston Scientific, Clevexel, Oxford Biomedica, Pfizer, and WebMD as a consultant and advisory board member. Dr. Goetz has received royalty payments from Elsevier Publishers, Oxford University Press, and Wolters Kluwer. Dr. Goetz has received research support from Rush University Medical Center and The Michael J. Fox Foundation. Dr. Truesdell has nothing to disclose. Dr. Stebbins has received personal compensation for activities with Acadia, Pharmaceuticals, Adamas Pharmaceuticals, Inc., Ceregene, Inc., CHDI Management, Inc., Ingenix Pharmaceutical Services (i3 Research), Neurocrine Biosciences, Inc., and Pfizer, Inc. Dr. Stebbins has received research support from National Institutes of Health, Michael J. Fox Foundation for Parkinson’s Research, Dystonia Coalition, CHDI, International Parkinson and Movement Disorder Society, and CBD Solutions. Dr. Weathers received compensation in an editorial capacity from the AAN for serving on the Test Your Knowledge work group.