Decreasing the barrier to access for patients with Amyotrophic Lateral Sclerosis (ALS) during COVID 19 pandemic: Our experience at University of PR



Poster Number: 131


Alexandra Montalvo MD, Brenda Deliz-Roldan MD, José Carlo MD, Tania Ginebra


1. Neuromuscular Fellow, 2. University of Puerto Rico, School of Medicine, Division of Neurology, 3. University of Puerto Rico, School of Medicine, Division of Neurology, 4. University of Puerto Rico, School of Medicine, Division of Neurology

Objective: To report the impact of telemedicine (TM) in the access of our ALS patients seen at our MCC during the COVID 19 pandemic period.
Background: TM has been an emerging field in recent years, originally created as a way to provide medical services to patients in remote locations. In Puerto Rico the practice of TM was only beginning to be recognized as an alternative, so it was not significantly used prior to the COVID 19 pandemic. There was not an infrastructure established in our institution as to offer this service for our patients. The Medical College of Physicians in Puerto Rico recommended a waiver for licensed physicians to provide this service irrespective of their certification status and obliged insurance to cover for these services amid the pandemic. In March 20, 2020, the governor of Puerto Rico signed a law that authorized physicians to practice telemedicine for the first time. Puerto Rico began one of the earliest lockdowns in the USA in March 2020. During this period medical services providing medical encounters only solely of TM was implemented. After the lockdown, in person encounters where gradually merged with TM services. The TM modality opened the possibility to reach patients that would have otherwise been isolated due to the accompanying limitations in transportation and access to physical facilities during the pandemic. Due to the complexity and chronicity of ALS patients, we readily applied the TM infrastructure to facilitate healthcare access as well as to limit risks in these patients. In this abstract, we present the impact of TM to outreach medical services to our ALS patients.
Design/Methods: We compared the number of ALS patients (in-person clinic), from January through December 2019 with the number of patients (in-person or TM clinic), that participated from January through December 2020 in our ALS clinics. Each patient was counted only once for each period.
Results: The total number of ALS patients for 2019 were 32, and 47 for the year 2020.
Conclusions: Our finding shows that the number of patients in our ALS clinics increased by 47% during 2020 as compared with 2019. This coincides with the availability of TM as a way to offer continuity of care to our patients. TM infrastructure practice in our ALS clinics was well received by patients and caregivers and provided us a with a basis to further expand and improve this service.