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“Telemedicine has the potential to take a great deal of burden off patients and families”
PD in Practice
sponsored by Abbott
Author: Johanna Stiefler JohnsonPublished: 7 April 2022
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Professor Daniel Weiss and Sabine, a person with Parkinson’s, talk about telemedicine – from its role in deep brain stimulation, to the potential benefits it can offer to people living with the condition. Hear why Sabine thinks the approach to treatment gives her a “special feeling of security”
One of the many global changes brought on by the Covid-19 pandemic has been the growing role of telemedicine – that is, treating patients remotely through digital technology. But how can it support people with Parkinson’s and what part can it play in deep brain stimulation (DBS)?
That’s the question that Germany-based neurology expert, Professor Daniel Weiss, hopes to answer.
“Telemedicine for Parkinson’s disease has always seemed to us to be a very promising concept, when used with care and rigorous security standards,” he says. “Through the pandemic, it has continued to make a lot of sense – to build bridges for patients and improve access to treatment.”
Allowing healthcare providers to “monitor their patients in real time, observe their therapy and even adjust it”, he says the technology brings “significant advantages to people with Parkinson’s disease – particularly in relation to DBS”.
As a senior consultant physician in the neurology department at the University Clinical Centre of Tübingen, Germany, Professor Weiss supports people living with movement disorders – and his research focuses primarily on managing therapy complications. “In conditions that cannot be adequately treated pharmacologically,” he says, “device-assisted therapies such as deep brain stimulation play an essential role in improving treatment for patients – and helping people with Parkinson’s to achieve a higher quality of life.”
Accessing remote support
That includes helping people like 64-year-old Sabine from Baden-Württemberg, Germany, who underwent DBS surgery in 2019.
“In 2004, I noticed that I would suddenly become very tired for no reason,” she says, reflecting on her first experiences of Parkinson’s symptoms, “and when I washed my hair, I couldn’t move my left hand as well as my right.”
At the age of 47, she was diagnosed with the condition. “I was worried about the future,” she says. While oral medication helped Sabine to manage the condition for many years, in 2019 she faced “a phase when I couldn’t cope”.
“I couldn’t do everyday actions with my hands. My head tried to tell them what to do, but they did not. It was difficult to get up from the edge of the bed or the sofa. I simply did not have the strength or the impulse to get up. It was a strange feeling.”
Dealing with insecurity, severe ‘off’ periods, sleep problems and weight loss, Sabine wanted to find a better way to manage the challenges of the condition as it progressed. “I was scared of surgery, but once I made up my mind, it was clear that this was an opportunity and I was going to take it.”
Having DBS surgery was like “flipping the switch”, Sabine says. And she explains it is not just her quality of life that has improved – but also access to treatment, thanks to telemedicine. She used to need to plan her day around visits to her doctor and travel long distances to appointments with an escort – but she can now receive some of her treatment remotely.
“Telemedicine makes it possible for me to schedule appointments at short notice, make adjustments to the treatment relatively easily and arrange things with my doctor as needed,” she says. “That gives me a very special feeling of security, which I did not necessarily have before – even when I am on the road. I can make contact when I travel or when I am in distant countries.”
Telemedicine: the good, the bad and the “optimised”
So what should healthcare professionals and people with Parkinson’s consider when it comes to telemedicine?
Professor Weiss explains that telemedicine currently works under three “essential” pillars: teleconsulting, which means communicating with patients in real time through remote consultations; home-based survey, which includes gathering everyday data from wearable devices to tailor treatment to each patient; and teletherapy, which allows healthcare professionals “to monitor patients in real time and adjust their therapy”.
“This means that patients, especially if they live far away geographically, will have easier access to treatment, requiring less effort and fewer costs,” he adds. “They can also be monitored more closely and, under everyday conditions, have their therapy optimised.”
One example of a platform that is helping to make this possible is NeuroSphere™ Virtual Clinic from medical company Abbott, which Professor Weiss explains “now allows healthcare providers to communicate with patients in real time, while maintaining full control over the stimulation and settings”.
But any use of healthcare technology comes with challenges and considerations. Security measures and privacy policies, for instance, are crucial to protect the confidentiality of those accessing care. “The whole server structure must be set up very securely,” says Professor Weiss, “so that appropriate data encryption takes place. This is guaranteed with NeuroSphere™ Virtual Clinic.”
Encryption helps to ensure that third parties cannot access confidential sessions unauthorised – while important steps are also taken to protect patients in instances of unreliable internet connection. “In a worst-case scenario, the connection could be interrupted, and I could lose control over my patient,” Professor Weiss says. “In this case, however, a safety mechanism would take effect – automatically resetting to the last safe setting.”
Another potential challenge is understanding how to use the technology itself, which may be difficult for some patients. “I would imagine,” reflects Sabine, “that some people are a little afraid of whether they will be able to handle this technology, or whether they will be dominated by the technology.”
She believes that this fear can be addressed by “educating patients early on – and also educating relatives on how to deal with the technical devices”.
Both Sabine and Professor Weiss agree that, with adequate consideration, there is much to be gained from technology in Parkinson’s treatment.
“I, for one, can say DBS has been worth it,” says Sabine. “Everyone has to decide for themselves, but for me it was an opportunity that paid off. I feel like I’ve won a new life.” She adds that, for her, telemedicine “has been a good experience – it’s easy to manage and can increase patients’ independence”.
Looking ahead to the future, Professor Weiss says: “Telemedicine has the potential, now and in the years to come, to take a great deal of burden off our patients and their families – as well as the healthcare system.”
Sabine agrees: “I think telemedicine is going to play a big role in the future, without replacing the face-to-face relationship with the doctor. It is simply an enrichment of the treatment possibilities – just one small piece of the ‘mosaic’ of aftercare.”
For more information on deep brain stimulation, please visit the EPDA website.
This article is sponsored by Abbott. The information in this article is given for information purposes only and does not represent an endorsement by the European Parkinson’s Disease Association of any particular treatments, products or companies. This article is not a substitute for advice from your doctor, pharmacist or other healthcare professional. Parkinson’s Life makes no representations or warranties of any kind, express or implied, about the completeness or accuracy of information provided.
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