Session Time: 12:45pm-1:45pm
Disclosures: Cria-May M. Khong, BS: No financial relationships or conflicts of interest
Objective : Improve patient engagement and access to care in individuals with Spinal Cord injury (SCI) through telemedicine (TM).
Design: Prospective observational cohort study.
Setting : Community Hospital.
Participants : 83 participants with SCI (age: 41.21 [std 16.21]; 65 males, 28 females; 58 tetraplegia, 25 paraplegia; 72 inpatient, 11 outpatient).
Interventions: Participants received an iPad, adaptive equipment, and data plan for a 6-month telemedicine intervention and monitoring from a SCI specialist.
Main Outcome Measures: Patient Health Questionnaire-9 (PHQ-9), Life Satisfaction Index A (LSIA), and Reintegration into Normal Living (RINL) were collected at baseline and 6-month follow-up. A program satisfaction survey (PSS) was collected at the 6-month follow-up. Healthcare utilization and patient-reported SCI compilations were collected monthly.
Results: The majority of TM encounters (166/198, 84%) were follow-up appointments; 21 individuals did not engage in TM. Bladder and bowel, musculoskeletal, psychological, pain, and SCI-specific symptoms ranked as the top 5 topics discussed. The within group (TM and non-TM) percent of participants engaging in at least 1 instance of other medical service were: Emergency room visits (non-TM: 26%, TM: 45%), hospitalizations (non-TM: 36%, TM: 23%), in-person physician visits (non-TM: 100%, TM: 95%), and sought advice (non-TM: 37%, TM: 66%). Whole group significant decreases in LSIA, from baselines to 3-month follow-up, were observed (Wilcoxon Signed Rank Test: Z=-2.16, p=.031). Whole group PHQ-9 and RINL did not show significant differences (p>.16). The program satisfaction survey revealed positive feedback in perceived health (74%), equipment satisfaction (88%), and program satisfaction (90%).
Conclusions: Individuals who participated in TM had greater health care utilization using the TM program for general follow-ups, as well as seeking advice within and outside of the program. TM may be an acceptable alternative to in-office visits, with benefits including decreased travel time and increased accessibility to SCI specialists, particularly for rural populations.
Level of Evidence: Level II
To cite this abstract in AMA style:Khong CM, Dirlikov B, Shem K. SCiPad: Increasing Access to Care using Telemedicine in Individuals with Spinal Cord Injury [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/scipad-increasing-access-to-care-using-telemedicine-in-individuals-with-spinal-cord-injury/. Accessed September 28, 2023.
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