The University of California Riverside is launching a pilot for patients to assess if video visits are a viable stand-in for in-person consultations with neurologists. 

Backed by a $100,000 grant from Genentech, UC Riverside — which opened its doors recently and will graduate its first class of medical students this year — is aiming to enroll 100 people, with half receiving in-office visits and the other half getting the virtual visits.

The home-based pilot will be conducted by a small team: just UCR professor and MS expert Elizabeth Morrison-Banks, MD, clinical assistant professor Kristyn Pellechia and a nurse practitioner. 

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Using videoconferencing tools from Polycom RealPresence or Vidyo, the nurse practitioner will go directly to the patient’s home and remotely connect with Morrison-Banks, who will perform a neurological assessment. This will involve an intake visit, a review of the patient’s history, discussion of lab results and neuro-imaging and treatment plans.

They will compare the telemedicine intervention group with the standard visits on a number of variables including pain and fatigue levels, visual impairment, bladder and bowel control, plus mental health, sexual satisfaction and overall quality of life.

“What we are looking for is if telemedicine can serve as a substitute for a physical visit. We’re not looking at remote monitoring or completely patient-directed telemedicine visits right now, but that is something we are definitely interested in down the line,” Morrison-Banks said. “Right now, it’s just to see if the format of the visit is acceptable to people, is it sufficient, do they have the full range of communication they would otherwise have in person?”

While there are a number of other telemedicine interventions for neurological conditions out there, such as those using the technologies to improve stroke or concussion treatment, MS is new territory. With the pilot, which is called CONNECT-MS, neurologists as well as Genentech will get more insights on how to blend therapies and technologies.

“It’s a difficult condition, especially for places that have general neurology services but don’t have MS-specific centers,” said Morrison-Banks. “And bringing in services and technologies in their offices poses challenges because they don’t always have the economies of scale they would if they were treating just one condition.”

Morrison-Banks developed the pilot based on lessons learned from a previous project (also funded by Genentech) she did in Ventura County in 2015, where they used video conferencing at a clinic to help teenagers with MS. That pilot was different in that it was conducted in-clinic and primarily functioned to help the physicians, but it provided valuable preliminary insights.

“Just like that earlier study, we’ll use this one to develop more tools,” said Morrison-Banks. “Maybe this won’t be effective, but if it is, we will look to scale up with other digital therapies available, like physical therapy apps or assessment tools. It would be great to look at those options in more pilots to see what does and doesn’t work for people, and adapt to those kinds of modalities.”

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