Telemedicine in MS: a discussion in the Brain Exchange chat rooms

Dr Agne Straukiene reported on the peer-to-peer discussion held on 11th September.

A colleague discussed how they have been using telemedicine exclusively and consistently for the past 3-4 months and shared feedback from their patients. They reported that patients have been positive about the virtual practices; and that they specifically:

• feel more supported by their communities,
• welcome the lack of parking and driving issues associated with attending clinics.

In discussing whether physical examinations are really possible via virtual appointments, peers shared their tips for how they conduct physical exams, and the room concluded that, in some ways, additional benefits can be gained through virtual appointments.

They specifically noted:

• body language and clues can be picked up on that are not always visible when seeing patients in a hospital clinic, because the individual is seen in a relaxed manner in their own environment.;
• Devices can be moved around in examinations,
  • such as putting a tablet or smart device on the floor to assess gait and mobility or
  • placing the camera on a coffee table or surface near a sofa, with an individual lying on the sofa to perform the heel-shin test

In discussing how often individuals with MS should be seen in virtual clinic, the general consensus was that this should be adapted from person to person, using patient reported outcomes to help tailor frequency to the needs of the individual.

Agne shared with peers the recent data from Northern Western University where 23,000 participants responded to a survey to evaluate whether people actively avoid accessing further information.

• Only 32% of respondents agreed to receive follow up information regarding a range of topics including retirement, lifestyle, lifespan, and so onl.
• Agne noted that this demonstrates that people often do not feel able to act on information.
• Looking at the MS field, people may feel that MS is a 'bad diagnosis' and that there is nothing they can do about it meaning they are unlikely to seek additional information on how to live well with MS, or about the lifestyle or pharmacological support they can access to improve their quality of life and prognosis.
• Agne noted that the study found that men seek more information on average than women and highlighted that, as MS affects more women than men, this may indicate a large volume of people who are not engaging in supportive information.
• How we get this engagement with people as we move into more telemedicine to help support and manage patients is an essential piece of the virtual puzzle.