Multiple Sclerosis (MS) and Parkinson’s Disease (PD) are chronic neurologic diseases that affect thousands of Veterans and require regular access to specially care for treatment.
The VA estimates that around 110,000 Veterans have PD and over 38,000 have MS. MS and PD rehabilitative therapy from community providers is limited or non-existent in some rural and remote areas. Long distances to facilities, transportation challenges, and provider shortages can exacerbate these issues.
Two VA Offices of Rural Health (ORH) Rural Promising Practice (RPP) with programs https://www.ruralhealth.va.gov/providers/promising_practices.asp are working to meet these challenges by offering MS and PD care through Clinical Video Telehealth (CVT).
The CVT program enables the VA to connect rural Veterans to specialized care in their own homes by conducting remote physical and neurologic exams. Initial CVT sites report a high degree of patient satisfaction, reduction in patient travel, and a decrease in missed appointments.
The ORH Veterans Rural Health Resource Center (VRHRC) founded in 2013 located in Gainesville, Florida is using CVT to help Veterans with MS receive comprehensive care including physical therapy.
The program over nine years has expanded their initial pilot site at the Gainesville VA Medical Center to nine VA “hub” sites as well as to many local Community Based Outpatient Clinics within their networks.
Based on the success of the CVT for Veterans with MS program, in 2020, the ORH VRHRC in Gainesville Florida, launched the CVT for Veterans with PD pilot program at the Cincinnati OHVA Medical Center.
The program’s goal is to deliver comprehensive care including rehabilitation by telehealth technology to rural Veterans with PD, by improving their access to the most effective therapies available for PD and also enables telerehabilitation and other disciplines of care to be delivered to the home.
Veterans with PD can now receive remote physical therapy and real-time screening and treatment, including balance, exercise, assistive device treatment and evaluation, during regularly scheduled clinic visits.
Veterans with PD who have cognitive impairments or who are wheelchair bound also have access to speech therapy and assistance with managing their daily routines and help developing a home exercise plan.
Since the PD program was implemented, there has been a 50% increase in the number of Veterans participating in the program which indicates a strong demand for telerehabilitation services within the VA. Reports also indicate that the CVT program has been effective and well received by Veterans and providers.
Another VA program in place at other sites using telehealth is the Remote Home-Based Delivery of Cardiac Rehabilitation which was developed in 2010 at the Iowa City VA Health Care System.
The remote care entails a weekly scheduled video and or phone appointments to address high risk factors for VA patients living with cardiac issues. Since the initial development, the program has been adopted at over 30 VA facilities.