PCORI funds Dissemination and Implementation projects to increase awareness and promote the use of PCORI research findings to improve healthcare practices and health outcomes. This project was funded to conduct dissemination and implementation activities for the results of the research project Do Video House Calls with a Specialist Help Get Care to People with Parkinson's Disease?.
What research finding is this project disseminating?
In a PCORI-funded research study, the researchers tested whether virtual care visits for patients with Parkinson’s disease were feasible and useful. In the virtual visits—also called telehealth visits—patients could attend an appointment with their doctor using a computer, tablet, or smart phone from home, rather than traveling to the doctor’s office. One group of patients in the study received their usual care from a local neurologist. A second group received their usual care plus up to four virtual visits from a Parkinson’s disease specialist licensed in their state. The team compared the two groups’ quality of life, quality of care, and time and distance traveled per visit.
The research team found that virtual visits were a feasible way for Parkinson’s disease patients to receive care: 98% of individuals in the virtual-visit group completed at least one telemedicine visit. Both patients and clinicians rated the visits highly, and patients preferred virtual visits to in-person visits. The virtual visits saved time for patients and their caregivers. The research team didn’t find a difference in health outcomes between the two groups.
Why is this research finding important?
Patients with Parkinson’s disease who don’t receive care from a neurologist within four years of diagnosis have an increased risk for declining health, loss of independence, and premature death. Over 40 percent of Medicare beneficiaries with Parkinson’s disease fall into this category. Virtual visits could improve access to specialty care for people who live too far away from a Parkinson’s disease specialist, have trouble leaving their homes, or cannot get to the doctor’s office for other reasons. However, few studies have looked at whether telehealth can work for these patients. This study showed that virtual care could work and that patients and physicians liked it.
What is the goal of the dissemination and implementation project?
In this dissemination project, the researchers are building on the telehealth services they tested in their original research study. The team has developed a care program, Parkinson’s Disease Care New York (PDCNY), to provide virtual care free of charge to a diverse group of 400–500 patients with Parkinson’s disease across New York State.
What is the project team doing?
The research team is expanding its telehealth services to include visits with doctors and nurses who specialize in conditions that often accompany Parkinson’s disease, such as dementia and depression. The team is also offering educational sessions for patients and their families on topics such as exercise and nutrition. The team will continue to identify ways to improve services based on feedback from patients, clinicians, and others involved in PCDNY.
PDCNY will deliver telehealth services to a more varied group of patients than those who participated in the original research study. The program will reach more people who lack access to nearby specialty care, ethnic and racial minorities, patients over 80 years old, and patients in nursing homes or who are homebound.
The project team will also work to build capacity on a national scale by training neurologists in providing telehealth care for Parkinson’s disease patients and by training professionals in physical therapy, speech therapy, and occupational therapy to provide better care for patients with Parkinson’s disease.
How is the project team evaluating its dissemination activities?
The project team is using data that PDCNY is regularly collecting to evaluate both the implementation approach and the effectiveness of the virtual visits provided in the PDCNY program. The team is tabulating the number of patients and caregivers served, demographic information, neurologist care within the past year, and nursing home or homebound status. The team is also tracking the number of remote sites (satellite clinics with technology to conduct virtual visits) implementing PDCNY; problems participants report in accessing the virtual care visits; and number of virtual care visits by patients.
The project team is collecting patient outcomes including quality of life, quality of care, caregiver burden, cognition (measured using the Montreal Cognitive Assessment), and depression (measured using the Geriatric Depression Scale).
How is the project team involving patients and others in this dissemination project?
The project team is working closely with Parkinson’s disease patients and organizations. In addition, the team has formed partnerships with technology companies and medical, telemedicine, insurer, and policy organizations. These stakeholders serve on the project’s advisory board, help to develop and provide training to clinicians, assist with solving problems that arise in implementing the program, and promote awareness of the virtual care approach and the project’s findings.
Learn more about PCORI’s Dissemination and Implementation program here.
Original PCORI-funded Project
Note: Results from the original project have completed PCORI's Peer Review and are available here.
Using Virtual House Calls to Get Patients with Parkinson’s Disease Access to Care
Ray Dorsey shares how the results of his PCORI-funded research project, which sought to help patients with Parkinson’s disease get better access to care that is more convenient, are being used to expand these virtual visits in New York through this PCORI Dissemination and Implementation award.