To assess the current utilization of telemedicine by patients with multiple sclerosis (pwMS) and conduct a thorough literature review.

PwMS face barriers accessing specialty care for evaluation and treatment. Telemedicine, the practice of clinical care at a distance with the aid of technology, may be a potential bridge to close the access gap for pwMS separated by distance or disability. The objective of this study was to investigate the types of telehealth being utilized and overall outcomes for pwMS and their providers.

A Boolean search of the medical literature was conducted between January 2000 and January 31, 2017. PubMed, EMBASE, PsycINFO, and the Cochrane databases, were used to identify all relevant citations. Two reviewers independently appraised the articles for meeting study criteria and for study quality using the CASP system. Financial costs of the telehealth applications were assessed.  National health system datasets from Optum, Truven and the Department of Veterans Affairs were assessed for telemedicine utilization for the years 2008-2010 and 2016.  All MS cases were identified by a validated algorithm and were matched to controls.

A total of 28 studies involving 3,352 participants met criteria for inclusion. Telemedicine interventions were classified and outcomes were assessed systematically by the following categories: general MS care; rehabilitation and exercise; and neuropsychology/mental health. Studies showed a range of outcomes with variable quality. Overall, long-term telemedicine management interventions, telerehabilitation, and remote clinical examinations were shown to be beneficial, cost-effective, and satisfactory for patients and providers.  Utilization of telemedicine within the Optum, Truven and VA health care systems is presented for MS and controls.

Telemedicine is a viable platform for delivering specialty MS care. Its use and reimbursement within health care systems is variable.  Optimal implementation and barriers to its use in the current health care system should be explored.