Telemedicine Expands Reach of Care for Parkinson's Patients

As part of health care reform, President Obama has repeatedly talked about promoting the wider adoption of effective telecommunications and health information technologies. Before he was elected he said he intended to invest $10 billion a year over the next five years to move the U.S. health care system to broad adoption of standards-based electronic health information systems. And he said he would also expand the use of telemedicine, using communications technology to bring important health care services to isolated rural communities.

While Congress now wrestles with Health Care Reform approaches and the political battles connected with this, there is growing evidence that telemedicine could revolutionize the medical care available in rural America, at least for some ailments.

One innovative telemedicine project, for example, is providing distant nursing home patients with Parkinson's disease access to neurologists at the University of Rochester Medical Center (URMC).A pilot study of the project - the results of which were released this month at the International Congress of Parkinson's Disease and Movement Disorders in Paris - demonstrates that the system can improve the quality of life and motor function of patients.

"This study shows that we can effectively deliver care for Parkinson's patients via telemedicine," said URMC neurologist Ray Dorsey, M.D."This system enables us to reach and provide a high level of care to patients who might otherwise not have access to a specialist."

Dorsey and his colleague Kevin Biglan, M.D. oversee the project and divide patient responsibilities between them.The effort is a joint initiative between URMC and the Presbyterian Home for Central New York in New Harford, a 250 bed nursing home near Utica and about 150 miles from Rochester.

When the nursing home opened in 2001, it was the first in the nation to offer specialized care to people with Parkinson's and other movement disorders in a nursing home setting.For years, the Parkinson's patients at the home would typically make 10 trips a year to Syracuse, Albany or Rochester to see a movement disorders specialist.Tony Joseph, the administrator of the Presbyterian Home says that these trips were exhausting for the home's elderly patients. "I knew there had to be a better way," said Joseph in a news release.

Joseph knew of Dorsey and Biglan through their work with the Parkinson Support Group of Upstate New York and approached them to seek their help in devising a solution.They struck an approach that utilized telemedicine to conduct patient visits that otherwise would have been burdensome or not possible for patients.

The expertise for such a project already existed in the Medical Center. URMC has one of the largest Movement and Inherited Neurological Disorders programs in the nation with more than 10 physicians and has been designated a Center of Excellence by the National Parkinson Foundation and the Huntington's Disease Society of America.

The Medical Center has also been an innovator in the field of telemedicine.The system employed for the project was built on a technological backbone developed at URMC and is used to conduct remote pediatric and dental evaluations on patients in schools, day care centers, and other locations.The system is essentially low tech, low cost solution and consists of a laptop, software, and a web camera that allows the physicians to interact with and visually assess patients.

While such remote evaluations have their limitations, Parkinson's disease was an ideal candidate for such a system. "Parkinson's is a very visual disease," said Biglan."You don't necessarily have to