To quantify the savings in resources when rehabilitation is offered at home using remote clinical supervision via a telehealth platform.

Telemedicine provide patients with treatment from home using remote supervision via videoconference. While initially established in rural settings, there is a significant need in urban settings. We have developed a remotely supervised telerehabilitation to study transcranial direct current stimulation (RS-tDCS) in patients living with multiple sclerosis (MS).  Participants were provided between 10 to 40 at-home tDCS treatment sessions and were surveyed to quantify benefits of home access.

Participants who participated in previous RS-tDCS trials were contacted to complete a follow-up survey. The survey inquired into participants’ travel patterns to clinic. Transportation time was calculated using the participant’s home address as a reference to the clinic location.

A total of n=52 participants completed the survey with a mean age of 47.7±14.5 years. A total of 59% (n=30) had relapsing-remitting multiple sclerosis, 28% (n=14) had secondary progressive multiple sclerosis, and 13% (n=7) had primary progressive subtypes. NYC participants lived an average of 5.4 ±3.4 miles from the clinic. Those living outside NYC lived an average of 73±70.4 miles away.

Travel costs: Participants spent an average of $25.40 on transportation. Average travel costs were higher for those traveling from outside NYC (mean $45.00 per visit) than for those within the NYC area, ($15.60 per visit). Travel burden was high, with 1.28 hours for those within NYC and 3.5 hours outside NYC required on average to reach the clinic.

The average participant had a cost of $25.40 and 2.39 travel hours per visit. Remote delivery of treatment saved patients time, money, the physical stress of travel, and provided access to those with more severe disability.  Findings strongly support the use of telehealth platforms for clinical and research visits.