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ALS Worldwide
January 27, 2015

Optimizing ALS Care for Veterans Through Telemedicine

Dr. Richard Bedlack, Director, Duke University ALS Clinic, shares information about his Telemedicine program.

"I have two roles, one as the Director of Duke University ALS Clinic and the other coordinating VISN6, also known as the Mid Atlantic Veterans Affairs Health Care Network program for the care of ALS/MND patients. There are approximately 600 veterans with ALS in VISN6. The Veterans Administration can provide many excellent benefits and services for these veterans. But there is a problem: Many veterans with ALS live in rural areas and thus may not be able to travel to an ALS-knowledgeable clinician. Indeed, only 15% of these veterans have seen a VA neurologist in the past six months. This may explain why only 75% of the veterans with ALS in VISN6 have service connection, only 40% are receiving riluzole and only 15% are getting multi-disciplinary care. 

We are trying to connect these veterans to ALS-knowledgeable clinicians via "telemedicine." Telemedicine utilizes web cameras and free software to establish secure connections between computers. We currently have two versions of this. In the Tele-ALS Clinic, I or another neurologist are on a desktop computer at the Durham Veterans Administration Medical Center, connecting with veterans and their families who are in their own homes on their desktops or laptops. In the Tele-Home Clinic, Rehabilitation Physician Dr. Helen Hoenig and her team of Occupational and Physical Therapists are on their desktop computers at the Durham VAMC while a trained Licensed Practical Nurse is sent out to the veteran's home with a laptop computer equipped with WiFi and a USB Webcam. This enables the rehabilitation providers to assess the veteran's functional abilities and needs in the actual environmental context where these tasks must be performed. 

These clinics have already helped veterans with ALS obtain new medications to modify treatable ALS symptoms, acquire new equipment to improve their independence and safety, and stay up to date with the latest ALS research findings. In the near future we hope to expand the number of multi-disciplinary team members that participate, add new technologies that will allow increased monitoring of important ALS prognosticators such as weight, diet and exercise, and grow the program into other parts of the country."

If you are a veteran with ALS, live in North Carolina, have a computer and want to try telemedicine, email Dr. Richard Bedlack