Telemedicine Gets Thumbs Up, MS Specialists Say

Most multiple sclerosis (MS) healthcare providers have used telemedicine to care for patients and want to keep using it, survey data showed.

Of MS providers across the country who completed an online survey, 76% said they’ve used telemedicine to see patients, reported Mitchell Wallin, MD, MPH, of George Washington University in Washington, and colleagues, in a study presented at ACTRIMS Forum 2021, the annual meeting of the Americas Committee for Treatment and Research in Multiple Sclerosis.

Video was the most common platform they used (87%), followed by phone (71%). Both video and phone visits increased during the COVID-19 pandemic, while other forms of virtual care — store-and-forward telemedicine (10.1%) and remote patient monitoring (1.4%) — were rare.

Many MS patients are separated by geographic distance and disability from MS clinical centers and 30% don’t receive specialty care, Wallin said. Telemedicine can fill some of that gap, which why this research project started 4 years ago, he noted.

“We didn’t have the COVID-19 pandemic in mind at that point,” he told MedPage Today. “Nonetheless, our group was able to extend the study over another year to capture the dramatic increase of telemedicine across all disciplines in 2020 — one of the silver linings of the pandemic.”

From November 2019 to September 2020, 91 MS providers completed a 34-question online survey. Neurologists (41%) were the largest group surveyed, followed by nurse practitioners and physicians assistants (29%), nurses (14%), and psychologists/neuropsychologists (8%).

Telemedicine use increased from 15% of practice encounters before the COVID-19 public health emergency to 73% of encounters during the pandemic. Nearly all (93%) MS specialists said they were very or somewhat satisfied with their last telemedicine visit, and 94% said they wanted to continue to use telemedicine.

The most common drawback of telemedicine was not being able to complete a full neurological exam, 85% of respondents said. About one in five practitioners also expressed concerns about privacy and security.

While telemedicine has great potential in MS care, its use was limited before COVID-19, noted Marisa McGinley, DO, of the Cleveland Clinic Mellen Center for Multiple Sclerosis, who wasn’t involved with the study.

“Many patients do not live close to a MS center,” McGinley told MedPage Today. “Telemedicine has the potential to provide greater access to specialized care, regardless of geographical location.”

But some areas need work to ensure telehealth provides quality care in the future, McGinley noted. “As mentioned by the authors, improved methods to reliably obtain objective remote neurological assessment data are needed,” she said.

“Additionally, a better understanding of patient perceptions around virtual care is needed, along with identifying potential barriers — such as payer coverage or WiFi availability — to ensure all patients have access to virtual care,” McGinley added.

Further study also is needed to evaluate how opinions about telemedicine have evolved as providers have become more accustomed to using it, and to identify barriers limiting store-and-forward telemedicine and remote patient monitoring, Wallin and colleagues noted.