Objective: To elicit healthcare professionals’ perspectives on the introduction of a clinical decision support system (CDSS) to facilitate Parkinson’s disease care provision: impact on current care; perceived barriers and facilitators to adoption; and evidence requirements for implementation in clinical practice.

Background: Parkinson’s care generally consists of regular in-person clinic-based reviews by a Parkinson’s specialist, typically lasting 20 minutes or less and taking place every 6–12 months; services are limited by capacity constraints and many symptoms may go unreported. A CDSS has been developed to support holistic care provision for patients able to engage in self-management of their Parkinson’s: Self-Management, Remote monitoring and Timely review for PD (SMaRT-PD). The CDSS utilises remote monitoring and artificial intelligence to generate patient and clinician-facing outputs with self-management guidance and care recommendations, and identify patients in need of clinical review.

Method: We undertook care pathway mapping and semi-structured interviews with healthcare professionals (movement disorder specialists (MDS) and Parkinson’s disease nurse specialists (PDNS)) working in a range of NHS secondary or tertiary care settings in England. Transcripts were evaluated by thematic analysis.

Results: Interviewees (8 MDS and 4 PDNS) described a current care pathway largely matching that outlined in guidelines, with limitations including time to diagnosis, inconsistent care, staff shortages, and challenges around appointment length and frequency. Potential advantages of a pathway utilising SMaRT-PD included patient empowerment and education, identification of patients in need of review, and optimisation of clinician time. Barriers to implementation were both clinical and administrative, with the primary concern being that both patients and staff would miss regular face-to-face appointments. The most important evidence requirement for adoption of such a pathway was patient, carer and staff satisfaction.

Conclusion: There was broad support for utilising SMaRT-PD in Parkinson’s services. CDSS-based pathways could provide an opportunity to concentrate limited resources where they are most needed. To be considered for adoption in clinical settings, evidence is needed of efficiency and system-wide benefit.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/transformation-of-parkinsons-care-through-self-management-remote-monitoring-and-timely-review-smart-pd-care-pathway-mapping-with-clinical-experts/