Session Information
Date: Saturday, November 16, 2019
Session Title: Annual Assembly Late Breaking Posters (Non Presentations)
Session Time: 11:15am-12:45pm
Location: Research Hub - Kiosk 8
Disclosures: Daniel Solomon, MD, MA: No financial relationships or conflicts of interest
Objective: Those with neurologic disease are often burdened not only by the condition itself, but also an increased need for subspecialty medical care at centers of excellence. For some, this requires that long distances be traveled, while for others, even small distances can be a hardship secondary to mobility and transportation issues. In recent years, telemedicine has been introduced to provide more convenient and improved patient care, however, telemedicine is not universally covered by some insurance carriers, including Medicare. We sought to examine the burden of time associated with clinical visits for those with neurologic disease and their family/caregivers.
Design: Over a 3-month period, all patients presenting to medical visits with a physical medicine and rehabilitation or neurourology provider were questioned using a short survey. Patients’ estimates of distance from home, travel time, and need for caregiver assistance to attend visits were examined.
Setting: Outpatient PM&R and neurourology clinic.
Participants: 208 patients with neurologic disability receiving subspecialty care.
Interventions: N/A
Main Outcome Measures: Round-trip travel time for patients and family/caregivers to clinic.
Results: Most patients (75%) lived within 25 miles of our clinics and experienced an average round-trip travel time of 79.4 minutes, though 9.7% required 3 hours or more. Additional family/caregiver assistance was required for 76% of patients, which resulted in an inclusive average commute time of 138.2 minutes per patient. Many patients (42%) perceived it difficult to attend their clinic visit with transportation difficulties, commute time, and changes to their daily schedule being the most commonly cited reasons.
Conclusions: Telemedicine has the potential to substantially improve time savings for those requiring subspecialty care for their neurologic disease. Giving a tablet device to each patient would reduce cost-per-minute of patient and family/caregiver time by $2.38, with greater savings for additional visits. Increased emphasis on telemedicine coverage for those with neurologic disability should be considered.
Level of Evidence: Level II