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Telemedicine in the Home for Veterans with Amyotrophic Lateral Sclerosis (P5.082)

R. Bedlack

Published 2014 in Neurology

ABSTRACT

Objective: To empower veterans with ALS to greater awareness of available benefits and evidence-based options for managing their illness. Background: Military veterans are more likely to contract ALS than non-veterans. As a result, veterans are entitled to 100% service connected disability for ALS. Not all veterans are aware of this. Only 288/557 of the veterans in our integrated service network (VISN) with ALS/MND currently have service connected disability benefits. There remains no cure for ALS but there are evidence-based interventions that prolong or enhance quality of life. These are typically administered through neurologists in urban multi-disciplinary ALS clinics. There are few of these clinics nationwide, none at veterans affairs medical centers (VAMCs) in our VISN. Zip codes of 557 veterans with ALS/MND in our VISN show that many live in rural areas, and are thus geographically unlikely to attend non-VAMC ALS clinics in far away urban areas. Indeed, only 65 of these veterans have had an encounter with any neurologist in the past 6 months. Based upon these observations there is a need to connect veterans with ALS/MND in our VISN to VAMC neurologists with ALS expertise. Design/Methods: We opened a VAMC telemedicine clinic that connects veterans with an ALS expert (RB). Veterans in their homes use their computer, webcam and secure Jabber connection to conference call with the expert at the Durham VAMC. A template guides information exchange based upon known VAMC ALS benefits and AAN ALS Performance Measures. Results: Enrolled veterans have had improved ALS care, including discontinuing riluzole with tracheostomy, treatment of pseudobulbar affect, spasticity, cramps, depression, anxiety and leg swelling, and repair of a broken power wheelchair and speech-generating device. They have also been able to hear hopeful ALS research updates. Conclusions: Telemedicine can empower veterans with ALS to a greater awareness of available benefits and evidence based care options. Disclosure: Dr. Bedlack has received personal compensation for activities with Pfizer Inc., Athena Diagnostics, Eli Lilly & Company, UCB Pharma, Guidepoint, Avanir Pharmaceuticals, and the ALS Association.

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