Objective: To assess telehealth patterns on socioeconomic and geographic factors and time to surgery in  patients with Parkinson’s Disease (PD) evaluated for deep brain stimulation (DBS) or high-intensity focused ultrasound (HIFU) at the West Virginia University (WVU) Medicine’s Multidisciplinary Movement Disorders Clinic (MDMC) (2017–2023).

Background: Conditions such as PD often require in-person evaluations for accurate diagnosis. During COVID-19, providers rapidly adopted telehealth to maintain care. In Appalachia, over half of residents live >60 miles from a specialist, suggesting telehealth could reduce travel burden and costs.

Method: We retrospectively reviewed patients with PD who underwent DBS or HIFU between January 1, 2017, and December 31, 2023. Demographics, appointment type (in-person vs telehealth), and travel costs (mileage rates) were recorded. Heat maps visualized spatial patterns; correlations assessed social determinants of health (SDOH) and time to surgery.

Results: From 01/01/2017 – 12/31/2023, 229 PD patients had 3,945 MDMC visits: 141 (3.6%) were via telehealth, while 3,183 (96.4%) were in person. Nineteen patients had ≥1 telehealth visit before surgery (29 total; mean 1.52/patient). On average, in-person visits cost $94.10 with 2.67 travel hours. Telehealth appointments saved $122.29 and 3.44 hours per visit (Table 1). Patients lived <60 miles (n=98), 60–180 miles (n=112), or >180 miles (n=19) from the clinic, with unique populations clustering in the southern part of the state for the telemedicine group (Figure 1). Time to surgery did not differ by distance (log-rank p=0.98) (Figure 2), and distance was not associated with telehealth use (χ²=2.43, p=0.487). Mean time to surgery was 1,101 days for telehealth patients vs. 759 days for non-telehealth (t=1.81, p=0.078). Higher education correlated with in-person visits, while higher unemployment correlated with telehealth use.

Conclusion: Reduced travel time and costs associated with telehealth visits, without delaying the time to surgery, represents a clinically meaningful advantage to telemedicine. Expanding access to underserved populations may improve equity in PD surgical care.

Table 1.

Figure 1. Heat map

Figure 2. Kaplan Meier survival analysis

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MDS Abstracts - https://www.mdsabstracts.org/abstract/benefit-of-telemedicine-usage-in-parkinsons-disease-patients-in-appalachia/