Telemedicine in an academic movement disorders center during covid-19

Abstract

Objective Telemedicine has rapidly gained momentum in movement disorder neurology during the coronavirus disease (CO-VID-19) pandemic to preserve clinical care while mitigating the risks of in-person visits. We present data from the rapid imple-mentation of virtual visits in a large, academic, movement disorder practice during the COVID-19 pandemic. MethodsaaWe describe the strategic shift to virtual visits and retrospectively examine elements that impacted the ability to switch to telemedicine visits using historical prepandemic in-person data as a comparator, including demographics, distance driven, and diagnosis distribution, with an additional focus on patients with deep brain stimulators. ResultsaaA total of 686 telemedicine visits were performed over a five-week period (60% of those previously scheduled for in-office visits). The average age of participants was 65 years, 45% were female, and 73% were Caucasian. Men were more likely to make the transition (p = 0.02). Telemedicine patients lived farther from the clinic than those seen in person (66.47 km vs. 42.16 km, p < 0.001), age was not associated with making the switch, and patient satisfaction did not change. There was a significant shift in the distribution of movement disorder diagnoses seen by telemedicine compared to prepandemic in-person visits (p < 0.001). Patients with deep brain stimulators were more likely to use telemedicine (11.5% vs. 7%, p < 0.001). ConclusionaaTelemedicine is feasible, viable and relevant in the care of movement disorder patients, although health care dis-parities appear evident for women and minorities. Patients with deep brain stimulators preferred telemedicine in our study. Further study is warranted to explore these findings.