The Future of Medicine?

Telemedicine offers better access to care for Parkinson's patients

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In 2004, telemedicine was listed as a key aspect of New York State's initiative to improve access and quality in health care through advances in technology. According to Gregory Young, MD, F.A.C.E.P, Medical Director, Western Region of New York State Department of Health, "Telemedicine is a critical part of the future of medicine."

A few years into the initiative, our local government took an active role in making this happen. According to Pressconnects, "The Southern Tier Regional Economic Development Council approved an initiative that would allow health care providers in the eight-county region to apply for $2.5 million in funding." 1 This initiative, called the Telemedicine and Mobile Technology Fund is expected to get the green light from the Empire State Development Corp. Board of Directors.

Programs such as the Community Revitalization Program and the Rural Initiative Program were established in 2012 using state economic development funds. The Telemedicine and Mobile Technology Fund, the latest in the line of these community revitalization initiatives, would use $2.5 million available from the second round of state funds.

Greater Access

Telemedicine means faster and easier access to your healthcare provider. Some clients favor remote visits due to difficulties associated with leaving their house, travel expenses, and occasional lapses in office schedules, leading to prolonged waiting or cancelations. Still others, dislike visiting a germ-ridden waiting room. In both cases, remote access to the medical team is the best solution. This is to say that telemedicine should be used to replace all office visits, but the ones that consist of subjective, rather than objective data gathering.

Susquehanna Nursing and Rehabilitation Center (SNRC) in Johnson City, New York has been offering televisits with a movement disorder specialist from University of Rochester for both inpatient and outpatient clients and clients living with movement disorders such as Parkinson's disease. "Where do I find a specialist who knows the recent research and understands my disorder and how do I get to him?" one of the local members of Southern Tier Parkinson's Support group posed to me. For most individuals this question is difficult to understand, but when one considers an individual who has difficulty moving due to rigidity, has urinary frequency, must stretch regularly, and in most cases, is not able to safely drive long distances independently, having easy access to a specialist that doesn't exist locally, is critical.

Kevin Biglan, MD, MPH, associate professor of neurology at University of Rochester has been researching the benefits of telemedicine in clients with Parkinson's disease for more than five years. He finds that having access to telemedicine allows for better treatment of symptoms, better satisfaction, and better quality of life for clients living with Parkinson's Disease.

Collaborative Care

Biglan has been working with Susquehanna Nursing and Rehabilitation Center for the past three years. In our facility, by involving a skilled therapist and a nurse as part of all the visits, telemedicine has prompted better multidisciplinary communication. Telemedicine allows for "real-time" visits (where a client can be seen when they are having specific symptoms), minimizes travel costs, including stress, as well as allows clinical staff easy access to Biglan, thus optimizing clients' quality of care.

Also Online!


Grant to Explore Telemedicine in Parkinson's

The Patient-Centered Outcomes Research Institute approved grants to deliver telemedicine care to people with Parkinson's

The downfall of this program is that insurance does not recognize telemedicine in our region, so  most clients have to pay for their visits out of pocket. SNRC holds annual fundraiser to assist clients who are not able to pay for the visits in the month of April, the official month to raise the awareness to find the cure for Parkinson's disease. Our facility has covered the cost of the visits for those clients residing at SNRC or staying here for short term rehabilitation.

Despite the cost of this program, monthly telemedicine schedule is always full. There is a large need in the community. Providing quality healthcare at a distance can be challenging and easily abused if the correct quality measures are not utilized, yet it is s a great solution for many.


1. "Southern Tier economic council approves fund for health care initiative." Pressconencts.com. July 27, 2013 http://www.pressconnects.com/article/20130627/BUSINESS/306270035/Southern-Tier-economic-council-approves-fund-health-care-initiative Accessibility verified Nov. 29, 2013.


Viktoriya Friedman, MSPT, c/LSVT is director of rehabilitation services at Susquehanna Nursing and Rehabilitation Center in Johnson City, New York and owner of VitalHealthSolutions, LLC.


Thank you for informing the PT practitioners on telehealth. Also,
There are wonderful resources at American Physical Therapy Association's practice webpage on telehealth.

There will be new toolkit on telehealth/telemedicine for physical therapist/physical therapy practitioners in 2014.

alan lee,  PhD, DPT,  Scripps MercyDecember 20, 2013
San Diego, CA


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