Importance of Telehealth Services for the MS Population

Bryant Robinson

(Credit: LinkedIn)

Since 2020, the Federal Government has significantly increased access to telehealth by waiving restrictions and broadening which services are covered. As a result, many providers and patients have embraced telehealth. For patients who have multiple sclerosis (MS) these telehealth services have become an increasingly important component of comprehensive care.

MS is a complex, unpredictable disease of the central nervous system that requires specialized training in neuroimmunology for accurate and timely diagnosis and treatment. There is no test that can be performed to confirm a diagnosis of MS. The diagnosis of MS is a process of elimination that requires a skilled clinician with extensive neurological acumen.

In addition to an early and accurate diagnosis, timely treatment with an MS disease-modifying therapy (DMT) has been shown to effectively minimize relapses, slow disease progression and result in better health outcomes.¹ Access to quality, comprehensive and personalized healthcare for diagnosis and treatment is essential for the best possible quality of life.

Unfortunately, access to such comprehensive and personalized healthcare is limited for many patients living in the United States. In a recent study that explored spatial access to neurologists and MS specialty care, the National MS Society (The Society) found that almost a quarter (23%) of the United States population are living in MS specialist deserts. These are areas with inadequate access to quality healthcare services. In these counties, patients with MS cannot reach an MS specialist in less than an hour. In addition, the Society’s data demonstrated that more than half (59%) of all U.S. counties do not have a neurologist located within county lines.²

The Society believes that telehealth is an important tool for overcoming the lack of coverage and can enhance timely access to specialized care. When a patient with MS seeks access to a neurology provider via telemedicine, they may be discussing:

• Strategies for managing the disease, including the use of disease-modifying therapies (DMTs);
• Adverse effect, safety and efficacy monitoring required for DMTs, often through lab tests and MRI;
• Assessing and treating relapses;
• Managing symptoms;
• Promoting function through rehabilitation;
• Lifestyle modifications, like healthy food choices, exercise and smoking cessation; and
• The impact MS is having on their work, family and social life.

Underscoring the importance of telehealth to the MS community, 94% of MS healthcare providers and 81% of patients with MS reported they want to continue using telehealth after the COVID-19 pandemic.^3,4 Unfortunately, many of the telehealth flexibilities that make access possible are set to expire at the end of 2024.

The Society has continued to urge Congress to make telehealth accessible and further expand access to care. In March, the Society held its annual Public Policy Conference where telehealth was one of the main topics of discussion. The conference culminated with hundreds of MS activists going to Capitol Hill to meet with their legislators and ask them to preserve telehealth flexibilities. Other activists, who had not attended the conference, complemented these meetings by sending additional messages to legislators urging their support for telehealth. In April, MS activist Jeanette Ashlock testified before the U.S. House of Representatives Energy and Commerce Health Subcommittee as part of a hearing on telehealth legislative proposals. Jeanette spoke on the importance of telehealth from the patient perspective and how such services are becoming an increasingly important part of care. 

Congress has responded to telehealth advocacy efforts as it remains a strongly bi-partisan issue on Capitol Hill. The House of Representatives has moved several telehealth bills through the legislative process. If enacted, these bills would protect the telehealth flexibilities set to expire at the end of the year. Many of these bills are expected to be included in a larger telehealth package, which will be voted on later this fall. We urge you to support and advocate for the continuation and expansion of telehealth services to best support your patients that you serve.

REFERENCES
1. Cerqueira JJ, Compston DAS, Geraldes R, et al. Time matters in multiple sclerosis: can early treatment and long-term follow-up ensure everyone benefits from the latest advances in multiple sclerosis?. J Neurol Neurosurg Psychiatry. 2018;89(8):844-850. doi:10.1136/jnnp-2017-317509
2. Barnola, A; Fiol, J; Snyder, M; Khatri, V; Daggitt, M; Rhea Rijhsinghani, R; VerValin, J; Martonik, R; Amezcua, L. The Identification and Characteristics of Neurological and Multiple Sclerosis Care Deserts across the United States. Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum 2024. Palm Beach, FL. 2024. Accessed July 10, 2024. https://journals.sagepub.com/doi/epub/10.1177/13524585241248739
3. Keszler, P; Maloni, H; Miles, Z.; Jin, S.; Wallin, M. George Washington University, VA Multiple Sclerosis Center of Excellence-East. (2021, Feb. 25). Telehealth Utilization and Perceptions of Multiple Sclerosis Health Care Providers. ACTRIMS 2021 Forum. https://www.abstractsonline.com/pp8/#!/9245/presentation/197
4. Wallin, M, personal communication, 2021, March 4. Preliminary Data: 2020 Patient Telehealth Satisfaction Survey.

National MS Society Clinical Fellowship Opportunity: The Society offers a one year, post-residency MS clinical fellowship program that is aimed to train neurologists or physiatrists who specialize in MS clinical care. This 12-month program allows fellows to have the opportunity to perform new patient consultations and follow-up assessments under an MS specialist physician. Also, fellows will partake in multidisciplinary team activities, lectures, and professional meetings, leading to the acquisition of skills and knowledge necessary to provide quality care for patients with MS. If you are interested in applying or would like to learn more about the Society's fellowship opportunities, click here.