The Future of Telemedicine in Multiple Sclerosis Patient Care

Telemedicine is appealing for health care professionals and patients alike because it helps provide health services to individuals at a distance. Could this technology become standard in the future for patients with multiple sclerosis (MS)? Genentech certainly thinks so.

Genentech has provided a 100,000 grant for a year-long pilot study of a home-based telemedicine program for MS patients.

“In 2015-2016, in collaboration with the Landon Pediatric Foundation, our research group developed a pilot telemedicine program for MS care funded by a Genentech research grant,” Elizabeth Morrison-Banks, MD, a health sciences clinical professor who is planning the study, said in a press release. “While our preliminary data suggested that telemedicine is effective for and acceptable to patients with MS, outreach was limited by the complexity of scheduling visits to the general neurologists’ officers in coordination with simultaneous telemedicine consultations. We are therefore proposing a new home-based telemedicine program.”

For the study, investigators will randomize adult patients withMSto receive either telemedicine-based care or standard care. A nurse practitioner (NP) will visit the homes of patients in the telemedicine group to review their clinical history, and to work with a neuroimmunologist who is on a telemedicine hookup to perform a neurological analysis.

The first home visit will occur 3 to 4 weeks after the patient enrolls in the trial, so the NP can to coordinate a HIPPA-protected telemedicine visit with Morrison-Banks.

The investigators will compare the health of patients in the telemedicine group with those in the standard care group for variables including pain levels, fatigue, visual impairment, bowel and bladder control, mental health, sexual satisfaction, and quality of life.

“The goal is to determine whether the home telemedicine approach works as well as usual care—–that is, office visits with the neuroimmunologist,” Morrison-Banks said. “This is a pilot study and it may not be able to show whether MS telemedicine in patients’ homes is better than usual care, but if it appears to be equivalent––and if patients and families like it better because of its convenience and comfort––then the pilot study will provide useful preliminary data to guide larger research studies in the future.”

Telemedicine or “tele-neurology” has become a popular approach of care for patients who have had a stroke. It provides rural communities with rapid access to qualified neurologists in the first minutes of an acute stroke.

Although telemedicine is not new, it is newer for the care of MS patients and has a different focus from acute stroke care. It can provide patients with access to fellowship-trained MS specialists in a way that has not been possible for this patient population.

“People with advanced MS face additional barriers to traveling to an MS center, even if it is located nearby, because if they have a lot of disability, over time it tends to become increasingly difficult for them to leave their homes,” Morrison-Banks said. “So if we can bring the ‘medical home’ into people’s actual homes, we can meet multiple needs at the same time while allowing a safe and comfortable environment for the medical visit.”

Morrison-Banks noted some challenges that may be met with integrating telemedicine into MS patient care.

“Some people may miss the face-to-face experience with the MS specialist,” Morrison-Banks said. “In our current telemedicine clinic for teens with MS, as one might expect, the teens adapt to the technology without missing a beat. I think these young people are going to lead the way for the rest of us in blending technological solutions into our everyday lives.”

NP Kristyn Pellecchia will be the co-investigator in the study and will visit patients’ homes to conduct the telemedicine visits and collect clinical research data.