'Virtual house calls' for Parkinson's as beneficial as office visits: study

“Virtual house calls” using Web-based videoconferencing are comparable to in-person physician office visits, according to a study conducted by researchers at Johns Hopkins and the University of Rochester (N.Y.) Medical Center. The study, which followed the care of 20 people with Parkinson's disease, demonstrated that virtual house calls can provide equivalent clinical benefits to patients, while also saving them time and travel.

The 20 study participants were randomly assigned to one of two groups, in which 11 were scheduled for three in-person doctor's appointments, while the remaining nine received three virtual house calls instead. Findings suggest that quality of care was no different between the two kinds of visits, but that telemedicine patients saved an average of 100 miles and three hours of travel time.

“It appears we can use the same technology Grandma uses to chat with her grandson to provide her with valuable medical care in her home,” Dr. Ray Dorsey, study leader and associate professor of neurology at the Johns Hopkins University School of Medicine, said in a release. “If this proof-of-concept study is affirmed, the findings open the door to a new era where anyone anywhere can receive the care she needs.”

However, wider implementation of remote care may face challenges under current Medicare and licensing rules. Doctors who offer virtual house calls are not reimbursed by Medicare for this kind of treatment, nor are physicians allowed to treat patients in a state in which they are not licensed.

“Reimbursement and licensure issues are trailing innovation and, if anything, act as a hindrance,” Dorsey said.

Research indicates that 42% of Medicare beneficiaries with Parkinson's disease did not receive neurological care in the first four years after their diagnosis. And those who do not see a neurologist are 20% more likely to die in the first six years following a diagnosis. They are also 14% more likely to fracture a hip and 21% more likely to be placed in a nursing home. According to Dorsey, the money that could be saved by preventing hospitalizations and skilled-nursing care would cover the costs of reimbursing neurologists who deliver care via telemedicine.

“Physician visits are a rounding error to Medicare in the economic scheme of things,” Dorsey said.

Parkinson's disease is a nervous system disorder that currently affects approximately 500,000 Americans; that number is anticipated to double over the next generation as the population ages. Symptoms include tremors, slowness of movement, stiffness and difficulty walking.