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Telemedicine Program Will Look to Extend Parkinson's Care Across New York State

May 9, 2016
by Rajiv Leventhal
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A virtual program launched by neurologists at the University of Rochester Medical Center (URMC) will aim to provide free care to as many as 500 underserved patients across New York state, according to a recent announcement.

Participants in the Parkinson's Disease Care, New York (PDCNY) program will interact via a web-based teleconferencing system with Parkinson's disease specialist at URMC.  There will be no charge for these virtual house calls. Physicians and nurses at URMC will develop and regularly reevaluate coordinated care plans for each patient, including referrals to speech, occupational, and physical therapists, mental health providers, social workers, and home health providers, if warranted, according to officials.

The PDCNY program will provide care to 500 patients, approximately 400 of whom will reside in the nine-county greater Rochester area.  An estimated 7,000 individuals with Parkinson's in the Rochester area have not seen a specialist in the last five years, officials said.

What’s more, participants with iPhones will be able to use the mPower app developed by URMC and Sage Bionetworks to track and share information about their symptoms with their physicians.  The app, initially designed as a research study using Apple's ResearchKit, uses sensors in the iPhone to measure dexterity, voice fluctuations, balance and gait, and memory. Now using CareKit, the latest software framework designed by Apple, is able to better inform patients and providers about their symptoms and care.

Officials of the program attest that Parkinson's disease lends itself to telemedicine because many aspects of the treatment of the disease are visual and only require the physician to observe the patient performing certain tasks such as repeatedly tapping their fingers together, walking, and describing their symptoms.  These exchanges can be conducted just as effectively via telemedicine as they can in a doctor's office and allow physicians to monitor the progression of the disease, manage and adjust medications accordingly, and refer the patient to other specialists, therapists, and support services, they said.

Additionally, geography is often a determining factor in whether a person with Parkinson's sees a specialist.  Neurologists with training in movement disorders like Parkinson's disease tend to be concentrated in major academic medical centers in large urban areas.  Additionally, the nature of the disease—particularly the impact on movement, balance, and coordination—can make frequent long trips to the doctor's office unfeasible.

"Providing coordinated, ongoing care to Parkinson's patients in the traditional settings of a doctor's office requires these individuals and their caregivers and families to travel, often long distances, and is expensive for payers and patients alike," URMC neurologist Kevin Biglan, M.D., the director of the PDCNY program, said in a statement. "The PDCNY program will break down the barriers of geography and deliver care directly to patients who have never seen a specialist and in the comfort of their own homes." 

The program is part of a growing movement to extend specialized neurological care to underserved populations. URMC neurologists already provide Parkinson's care via telemedicine directly to patients in New York state nursing homes located in New Hartford, Johnson City, Watertown, and Otsego.  The team will also be providing care for Huntington's disease patients at a new neurodegenerative nursing home that will open in Utica, N.Y. in June.

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