Use of telehealth during COVID-19 pandemic to secure durable medical equipment for patients with neuromuscular disease

Topic:

Clinical Management

Poster Number: 97

Author(s):

Cara Yochai PT, DPT, Donnielle Rome-Martin OTR/L, ATR, Jacqueline Montes PT, EdD, Bob Connelly ATP, Claudia Chiriboga MD, MPH, Michio Hirano MD

Institutions:

1. Columbia University Medical Center, 2. Columbia University Medical Center, 3. Department of Neurology, Columbia University Irving Medical Center, 4. Numotion: Wheelchair and Mobility Equipment Company, 5. Columbia University Medical Center, 6. Columbia University Medical Center

Neuromuscular diseases (NMD), like spinal muscular atrophy (SMA) and Duchenne muscular dystrophy, (DMD) are progressive and require timely durable medical equipment (DME) including wheelchairs and standers1. Historically, attaining DME through third party payers requires face-to-face visits with providers using multiple trials and measurements. With the emergence of COVID-19, telemedicine became immediately necessary to provide standard of care, and specifically to attain necessary DME. With stay-at-home orders, many patients were without access to their usual DME clinics. Continuation of comprehensive care is encouraged by experts in DMD and SMA communities2. The pandemic has affected the way care is delivered3, illuminating the need for a modified process to attain essential DME.
The purpose of this study was to (1) describe the process and outcomes in securing DME for individuals with NMD using a hybrid telehealth model, and (2) highlight a detailed timeline from initial evaluation to delivery, using a case series format.
Beginning March 2020 through December 21, 2020, 24 telehealth equipment evaluations for various devices took place for 20 patients through the Pediatric Neuromuscular Center. There were two methods: 100% remote and 50% remote/50% in-person. Mean time from initial evaluation to delivery was 74 days (range 42 – 231 days). Twenty pieces of equipment were approved and delivered. One custom power wheelchair was denied but ultimately approved through appeal. Another manual wheelchair was denied but later paid for privately. One power and manual wheelchair are awaiting authorization.
Preliminary findings indicate feasibility to use a telehealth model to secure DME for individuals with NMD. The time for initial evaluation to delivery was similar to previous in-person models. Telehealth decreases the burden placed on patients and reduces in-person visit cancellations. Telehealth may be a useful model in the future when accessibility, weather, or other health concerns threaten traditional delivery models of care.