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Reducing Barriers To Care For Patients With Parkinson’s And Other Chronic Diseases



May 29th, 2014

Editor’s note: For more on this topic, see the February issue of Health Affairs, which features a series of articles on connected health. 

It is one of the greatest ironies of our time that the United States is home to some of the highest-quality medical care in the world, yet millions of Americans cannot access it. This problem is all too familiar for Parkinson’s patients who could receive better clinical outcomes simply by being connected to a specialist outside of their immediate vicinity.

Every year, approximately 60,000 people in the U.S. are diagnosed with Parkinson’s disease, a chronic, progressive neurological disease for which there is no cure. But there is hope.

The TELE-MED Act

With the use of technology, there is an easy way to allow patients to integrate their complex disease management into their daily lives while eliminating frequent and disruptive travel. Unfortunately, this option – popularly known as telemedicine – is not properly regulated, and lawmakers need to update licensure regulations though common sense solutions such as the TELE-MED Act (HR 3077).

This bipartisan measure introduced by Congressmen Nunes (R-CA) and Pallone (D-NJ) would enable health care providers in the Medicare program to treat Medicare patients virtually across state lines without having to obtain additional state medical licenses.

One such group that would benefit from this available technology are those managing chronic conditions such as Parkinson’s disease. Parkinson’s patients, many of which rely on Medicare, are often destined for an expensive life of frequent travel to appointments, both near and far from home. It takes a team of doctors, such as a primary care physician, neurologist, or physical therapist, to sustain their quality of life. Often times someone like a movement disorder specialist can treat a patient best, but specialists may be few and far between.

Closing the Gap

Gary Chard, the State Director of the Delaware Parkinson Action Network who testified in front of the United States House of Representatives Committee on Energy and Commerce Subcommittee on Health, was diagnosed with Parkinson’s disease six years ago and is one of about 2,000 people living with Parkinson’s in Delaware, where not a single movement disorder specialist practices.

In fact, the closest specialist is 75 miles away in Baltimore, Maryland. However, Chard has been regularly seeing a neurologist and movement disorder specialist who practices 300 miles away in Rochester, New York through video conference technology at the University of Delaware’s Parkinson’s Clinic. Chard believes that these virtual appointments enable him to have critical care that he would otherwise not have access to.

Gary is not unique. In fact, in 2013, over 10.5 million patients in the Kaiser Permanente system utilized telemedicine to connect with their care provider. This demonstrates a growing trend of patients who not only want, but often need, telemedicine to fully manage their health conditions. People with Parkinson’s are included in this growing group of American consumers who need telemedicine to improve outcomes, decrease cost, and experience a full life while living with a chronic disease.

Implications for Legislation

Telemedicine is both a common sense and forward-looking practice for people with Parkinson’s and those suffering from many other diseases. For people with Parkinson’s, video chat enables health providers to witness the patient’s movement and make high-quality evaluations.

Though health providers can apply for licensure in multiple states, the process is both tedious and expensive, discouraging doctors and other health professionals from taking the leap even when it is in the interest of the general public.

The concept of only seeing doctors within your own state lines is an archaic remnant of a former time in America before computers, smartphones, and widespread broadband connectivity. Our regulations are far behind where they should be, and are not adapting quickly enough to the needs of patients and consumers.

Congress needs to recognize the vast implications of telemedicine, look to solutions such as the TELE-MED Act that do not impede access to care for millions of Americans, and consider supporting current efforts that would deliver enormous benefits for patients living with Parkinson’s disease and many others.

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1 Response to “Reducing Barriers To Care For Patients With Parkinson’s And Other Chronic Diseases”

  1. S Lattuca Says:

    I’ve had Parkinson’s for 12+ years now and find it impossible to leave my home, even for doctor appointments. I have had a wonderful neurologist who has a particular interest (his wording) in Parkinson’s. I had always thought that he’d see me through to the end. But now that the end is nigh, he’s said the only way he will see me is if I go to this office.

    I’ve suggested phone calls and Skype, but he has declined, saying he needs to see me in person.

    So this article interests me because it supports the approach that my doctor has repeatedly refused to consider.

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