Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond

Based on the results from the Living with the Impact of a Neurological Condition (LINC) project, those with chronic neurological conditions use more health care services across the continuum compared to other chronic health conditions.2 In a study from British Columbia, physician service utilization...

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Veröffentlicht in:Canadian journal of neurological sciences 2020-09, Vol.47 (5), p.594-597
Hauptverfasser: Appireddy, Ramana, Jalini, Shirin, Shukla, Garima, Boissé Lomax, Lysa
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container_issue 5
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container_title Canadian journal of neurological sciences
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creator Appireddy, Ramana
Jalini, Shirin
Shukla, Garima
Boissé Lomax, Lysa
description Based on the results from the Living with the Impact of a Neurological Condition (LINC) project, those with chronic neurological conditions use more health care services across the continuum compared to other chronic health conditions.2 In a study from British Columbia, physician service utilization is 1.4–5.6 times higher in people with chronic neurological conditions, as are the total direct health costs and out-of-pocket expenses for people affected by chronic neurological conditions.1 There are also limitations in health care services for this population with the physical environment cited as one of the significant barriers to the provision of adequate services. [...]the burden of neurological diseases is not only shared by the individuals and families affected by it but also by the health care system. Digital health solutions are also adopted by the federal and provincial authorities as a key priority area of innovation to reduce health care costs.8,9 There is also growing demand by patients to have access to such services, as seen in a 2018 nationally representative survey of Canadians’ opinions on health care access.10 Our experience with virtual care in neurology We have successfully implemented eVisit pilot project in 2018 in the stroke clinic. The results of our pilot study demonstrated a very high degree of patient satisfaction, reduction in per capita health care costs, out of pocket expenses [mean(SD): $74.92(57.99) CND; median(IQR): $52.83(31.26–94.53) CND], health system costs (range between $23,832 to $28,584 dollars, just from the pilot), and statistically significant reduction in wait times for an eVisit follow-up compared to in-person follow-up.11 Physicians were able to assess patients more quickly via eVisit than via an in-person encounter, thus increasing the timely availability of health care.12 Adopting virtual care solutions can also result in a significant reduction in costs.13 The cost saving is a conservative estimate, and the actual figures are likely higher if other factors and social determinants like childcare, income status, other personal factors, and visit characteristics were accounted for. Physicians and other health care providers benefit from eVisit’s flexible scheduling, which allows being more productive with their time, enabling them to distribute their clinical activity to accommodate other commitments, including teaching, research, and administration.20 In addition to increased productivity, eVisits have the pote
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[...]the burden of neurological diseases is not only shared by the individuals and families affected by it but also by the health care system. Digital health solutions are also adopted by the federal and provincial authorities as a key priority area of innovation to reduce health care costs.8,9 There is also growing demand by patients to have access to such services, as seen in a 2018 nationally representative survey of Canadians’ opinions on health care access.10 Our experience with virtual care in neurology We have successfully implemented eVisit pilot project in 2018 in the stroke clinic. The results of our pilot study demonstrated a very high degree of patient satisfaction, reduction in per capita health care costs, out of pocket expenses [mean(SD): $74.92(57.99) CND; median(IQR): $52.83(31.26–94.53) CND], health system costs (range between $23,832 to $28,584 dollars, just from the pilot), and statistically significant reduction in wait times for an eVisit follow-up compared to in-person follow-up.11 Physicians were able to assess patients more quickly via eVisit than via an in-person encounter, thus increasing the timely availability of health care.12 Adopting virtual care solutions can also result in a significant reduction in costs.13 The cost saving is a conservative estimate, and the actual figures are likely higher if other factors and social determinants like childcare, income status, other personal factors, and visit characteristics were accounted for. Physicians and other health care providers benefit from eVisit’s flexible scheduling, which allows being more productive with their time, enabling them to distribute their clinical activity to accommodate other commitments, including teaching, research, and administration.20 In addition to increased productivity, eVisits have the potential to address some of the significant contributors to physician burnout (work and organizational factors), which, in turn, can have consequences on patient care and health care costs.21 eVisit also reduces the need for admin/nursing support typically needed in the clinic setting, thus further reducing the overhead costs.</description><identifier>ISSN: 0317-1671</identifier><identifier>EISSN: 2057-0155</identifier><identifier>DOI: 10.1017/cjn.2020.92</identifier><identifier>PMID: 32394872</identifier><language>eng</language><publisher>New York, USA: Cambridge University Press</publisher><subject>Ambulatory care ; Ambulatory Care - standards ; Ambulatory Care - trends ; Betacoronavirus ; Burnout ; Canada - epidemiology ; Chronic illnesses ; Commentary ; Coronavirus Infections - epidemiology ; Coronavirus Infections - therapy ; Coronaviruses ; Costs ; COVID-19 ; Disease ; Epilepsy ; Health care ; Health care access ; Health care expenditures ; Health care policy ; Health services ; Humans ; Multiple sclerosis ; Nervous System Diseases - epidemiology ; Nervous System Diseases - therapy ; Neurology ; Pandemics ; Pandemics - prevention &amp; control ; Patient satisfaction ; Physicians ; Pilot projects ; Pneumonia, Viral - epidemiology ; Pneumonia, Viral - therapy ; SARS-CoV-2 ; Scheduling ; Sleep ; Stroke ; Telemedicine ; Telemedicine - standards ; Telemedicine - trends ; Video teleconferencing</subject><ispartof>Canadian journal of neurological sciences, 2020-09, Vol.47 (5), p.594-597</ispartof><rights>Copyright © The Author(s), 2020. Published by Cambridge University Press on behalf of The Canadian Journal of Neurological Sciences Inc.</rights><rights>Copyright © The Author(s), 2020. Published by Cambridge University Press on behalf of The Canadian Journal of Neurological Sciences Inc. This work is licensed under the Creative Commons Attribution License http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>The Canadian Journal of Neurological Sciences Inc. 2020 2020 The Canadian Journal of Neurological Sciences Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c555t-7780311dafdc6ade67dbdb11c0a89239e242e64d7426979ea88645cb8d5775e63</citedby><cites>FETCH-LOGICAL-c555t-7780311dafdc6ade67dbdb11c0a89239e242e64d7426979ea88645cb8d5775e63</cites><orcidid>0000-0003-1831-5804</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.cambridge.org/core/product/identifier/S031716712000092X/type/journal_article$$EHTML$$P50$$Gcambridge$$Hfree_for_read</linktohtml><link.rule.ids>164,230,314,776,780,881,27901,27902,55603</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32394872$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Appireddy, Ramana</creatorcontrib><creatorcontrib>Jalini, Shirin</creatorcontrib><creatorcontrib>Shukla, Garima</creatorcontrib><creatorcontrib>Boissé Lomax, Lysa</creatorcontrib><title>Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond</title><title>Canadian journal of neurological sciences</title><addtitle>Can. J. Neurol. Sci</addtitle><description>Based on the results from the Living with the Impact of a Neurological Condition (LINC) project, those with chronic neurological conditions use more health care services across the continuum compared to other chronic health conditions.2 In a study from British Columbia, physician service utilization is 1.4–5.6 times higher in people with chronic neurological conditions, as are the total direct health costs and out-of-pocket expenses for people affected by chronic neurological conditions.1 There are also limitations in health care services for this population with the physical environment cited as one of the significant barriers to the provision of adequate services. [...]the burden of neurological diseases is not only shared by the individuals and families affected by it but also by the health care system. Digital health solutions are also adopted by the federal and provincial authorities as a key priority area of innovation to reduce health care costs.8,9 There is also growing demand by patients to have access to such services, as seen in a 2018 nationally representative survey of Canadians’ opinions on health care access.10 Our experience with virtual care in neurology We have successfully implemented eVisit pilot project in 2018 in the stroke clinic. The results of our pilot study demonstrated a very high degree of patient satisfaction, reduction in per capita health care costs, out of pocket expenses [mean(SD): $74.92(57.99) CND; median(IQR): $52.83(31.26–94.53) CND], health system costs (range between $23,832 to $28,584 dollars, just from the pilot), and statistically significant reduction in wait times for an eVisit follow-up compared to in-person follow-up.11 Physicians were able to assess patients more quickly via eVisit than via an in-person encounter, thus increasing the timely availability of health care.12 Adopting virtual care solutions can also result in a significant reduction in costs.13 The cost saving is a conservative estimate, and the actual figures are likely higher if other factors and social determinants like childcare, income status, other personal factors, and visit characteristics were accounted for. Physicians and other health care providers benefit from eVisit’s flexible scheduling, which allows being more productive with their time, enabling them to distribute their clinical activity to accommodate other commitments, including teaching, research, and administration.20 In addition to increased productivity, eVisits have the potential to address some of the significant contributors to physician burnout (work and organizational factors), which, in turn, can have consequences on patient care and health care costs.21 eVisit also reduces the need for admin/nursing support typically needed in the clinic setting, thus further reducing the overhead costs.</description><subject>Ambulatory care</subject><subject>Ambulatory Care - standards</subject><subject>Ambulatory Care - trends</subject><subject>Betacoronavirus</subject><subject>Burnout</subject><subject>Canada - epidemiology</subject><subject>Chronic illnesses</subject><subject>Commentary</subject><subject>Coronavirus Infections - epidemiology</subject><subject>Coronavirus Infections - therapy</subject><subject>Coronaviruses</subject><subject>Costs</subject><subject>COVID-19</subject><subject>Disease</subject><subject>Epilepsy</subject><subject>Health care</subject><subject>Health care access</subject><subject>Health care expenditures</subject><subject>Health care policy</subject><subject>Health services</subject><subject>Humans</subject><subject>Multiple sclerosis</subject><subject>Nervous System Diseases - epidemiology</subject><subject>Nervous System Diseases - therapy</subject><subject>Neurology</subject><subject>Pandemics</subject><subject>Pandemics - prevention &amp; 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J. Neurol. Sci</addtitle><date>2020-09-01</date><risdate>2020</risdate><volume>47</volume><issue>5</issue><spage>594</spage><epage>597</epage><pages>594-597</pages><issn>0317-1671</issn><eissn>2057-0155</eissn><abstract>Based on the results from the Living with the Impact of a Neurological Condition (LINC) project, those with chronic neurological conditions use more health care services across the continuum compared to other chronic health conditions.2 In a study from British Columbia, physician service utilization is 1.4–5.6 times higher in people with chronic neurological conditions, as are the total direct health costs and out-of-pocket expenses for people affected by chronic neurological conditions.1 There are also limitations in health care services for this population with the physical environment cited as one of the significant barriers to the provision of adequate services. [...]the burden of neurological diseases is not only shared by the individuals and families affected by it but also by the health care system. Digital health solutions are also adopted by the federal and provincial authorities as a key priority area of innovation to reduce health care costs.8,9 There is also growing demand by patients to have access to such services, as seen in a 2018 nationally representative survey of Canadians’ opinions on health care access.10 Our experience with virtual care in neurology We have successfully implemented eVisit pilot project in 2018 in the stroke clinic. The results of our pilot study demonstrated a very high degree of patient satisfaction, reduction in per capita health care costs, out of pocket expenses [mean(SD): $74.92(57.99) CND; median(IQR): $52.83(31.26–94.53) CND], health system costs (range between $23,832 to $28,584 dollars, just from the pilot), and statistically significant reduction in wait times for an eVisit follow-up compared to in-person follow-up.11 Physicians were able to assess patients more quickly via eVisit than via an in-person encounter, thus increasing the timely availability of health care.12 Adopting virtual care solutions can also result in a significant reduction in costs.13 The cost saving is a conservative estimate, and the actual figures are likely higher if other factors and social determinants like childcare, income status, other personal factors, and visit characteristics were accounted for. Physicians and other health care providers benefit from eVisit’s flexible scheduling, which allows being more productive with their time, enabling them to distribute their clinical activity to accommodate other commitments, including teaching, research, and administration.20 In addition to increased productivity, eVisits have the potential to address some of the significant contributors to physician burnout (work and organizational factors), which, in turn, can have consequences on patient care and health care costs.21 eVisit also reduces the need for admin/nursing support typically needed in the clinic setting, thus further reducing the overhead costs.</abstract><cop>New York, USA</cop><pub>Cambridge University Press</pub><pmid>32394872</pmid><doi>10.1017/cjn.2020.92</doi><tpages>4</tpages><orcidid>https://orcid.org/0000-0003-1831-5804</orcidid><oa>free_for_read</oa></addata></record>
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subjects Ambulatory care
Ambulatory Care - standards
Ambulatory Care - trends
Betacoronavirus
Burnout
Canada - epidemiology
Chronic illnesses
Commentary
Coronavirus Infections - epidemiology
Coronavirus Infections - therapy
Coronaviruses
Costs
COVID-19
Disease
Epilepsy
Health care
Health care access
Health care expenditures
Health care policy
Health services
Humans
Multiple sclerosis
Nervous System Diseases - epidemiology
Nervous System Diseases - therapy
Neurology
Pandemics
Pandemics - prevention & control
Patient satisfaction
Physicians
Pilot projects
Pneumonia, Viral - epidemiology
Pneumonia, Viral - therapy
SARS-CoV-2
Scheduling
Sleep
Stroke
Telemedicine
Telemedicine - standards
Telemedicine - trends
Video teleconferencing
title Tackling the Burden of Neurological Diseases in Canada with Virtual Care During the COVID-19 Pandemic and Beyond
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