Australian clinicians’ experience with telehealth in a multiple sclerosis outpatient clinic during the COVID-19 pandemic has shown that a hybrid model is likely the best way forward.
An investigation into the impact of telehealth on services at a Melbourne hospital during the COVID-19 pandemic found that telehealth was well liked but had significant drawbacks in some areas.
Clinicians were more likely to record worsening disability scores for people experiencing multiple sclerosis at face-to-face appointments, compared to telehealth consultations, the study revealed.
The findings based on experiences of patients and clinicians at the the MS Centre, Royal Melbourne Hospital clinic from March to December 2020, showed that Expanded Disability Status Scale (EDSS) increases were recorded in 31% of face-to-face visits and 20% of telehealth consults.
This was particularly marked for patients with lower baseline disability (36% face-to-face compared to 16% at telehealth).
Despite the EDSS results, however, the study found no significant delays in the identification of increased disability status for patients, and rates of commencement for disease-modifying therapy were similar across the two consultation methods.
“Telemedicine-based physical assessments are feasible, but clinicians should be aware of limitations and how they compare with in-person examination,” the paper published in Multiple Sclerosis and Related Disorders, concluded.
“Clinicians should consider whether treatment inertia influence management decisions during telehealth consultations,” the authors said.
Hybrid model
One of the co-authors, Dr Vivien Li, told the limbic the best way forward for telehealth should be determined in an individualised way for each patient.
“In stable patients with a defined diagnosis, a hybrid model of alternating face-to-face and telehealth visits can be feasible and acceptable,” she said.