What to Know About Telehealth for Parkinson's Disease

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Parkinson’s disease (PD) is caused by the death of cells in the brain that normally produce dopamine (a chemical messenger that regulates body movements). Therapies to help manage PD include medications, physical therapy, and occupational therapy, but access to these treatments was challenging at the start of the COVID-19 pandemic.

Fortunately, telehealth services emerged and became a viable means of receiving health care while minimizing patients' risk of contracting or transmitting the virus.

Telehealth: Receiving Care for Your Parkinson's Disease at Home


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When to Use Telehealth for Parkinson's Disease

Many medical issues regarding Parkinson's disease can be addressed through telehealth. You may consider scheduling a telehealth visit with your neurologist or their nurse practitioner (their office will likely decide which provider is appropriate) for the following purposes:

  • To engage in a regular (usually annual or bi-annual) check-up
  • To review the effects of medications, medication side effects, or refill a medication
  • To discuss a new or recurring physical or mental symptom (e.g., worsening stiffness, constipation, insomnia, or irritability)
  • To troubleshoot a specific disease-related complication (e.g., unpredictable "off" episodes)

There are, however, instances in which a telehealth visit is not appropriate. A prime example would be a new diagnosis of Parkinson's disease. Diagnosing PD is often a complex process that requires a hands-on, clinical assessment.

You may also need to be seen in person if your health status has changed significantly from a prior visit. For instance, if you are experiencing significantly more falls, significant confusion or hallucinations, or are experiencing severe depression with weight loss, your neurologist will probably want to see you in person.

Likewise, if you have a new symptom that requires testing or laboratory work, an in-person visit may be warranted. For example, if you are experiencing new-onset fatigue, your doctor will probably want to see you in their clinic for a physical exam and bloodwork. Fatigue, while common in PD, may be related to another health problem.

Benefits and Challenges

The goal of telehealth visits is to mimic in-person healthcare provider visits within the comfort and safety of a person's own home.

For patients with Parkinson's disease, telehealth is of particular benefit, considering many patients have impaired mobility, cannot drive, and/or are homebound.

Besides these logistical benefits, research has found that patients with PD are highly satisfied with their virtual visits. This level of satisfaction may help foster a more robust, trusting patient-provider relationship than before and perhaps, improve adherence to medical guidance.

Of course, there are challenges posed by telehealth. For patients with PD, neurologists cannot perform a complete neurological exam. There is also a reasonable concern for privacy and security. As telehealth expands and becomes more regulated, this will hopefully become less of an issue.

Technological issues are also something to consider, especially in patients with PD. The ability to access and use a computer or smartphone may be impaired. Likewise, the quality of a person's camera, and whether they have a stable, high-speed Internet connection can negatively affect the quality of a virtual visit.

How to Prepare for a Telehealth Visit for Parkinson's Disease

If you are interested in participating in a telehealth visit, your first step is to call your insurance company or payor to verify your benefits and copay responsibilities.

When you have clarified your coverage, contact your healthcare provider to see if they participate in telehealth. If they do, and your provider agrees that this form of care is an appropriate option for you, you can proceed with scheduling your telehealth visit.

If your neurologist (or another healthcare provider) is not participating in telehealth, you may consider asking them or your primary care physician for a referral to another provider who is. This may be a temporary solution for you during the pandemic.

Will Insurance Cover Telehealth for Parkinson's Disease?

Insurance coverage for telehealth will vary by insurer, but it has been expanded during the COVID-19 pandemic. Clarify with your insurer what types of technologies are covered. Some insurance companies and payers, including Medicare and Medicaid, may impose restrictions.

For instance, your payor may only reimburse for telehealth technologies involving videoconferencing. They may not cover phone consultations or text messaging through a computer or smartphone.

If you do not have insurance or are OK with paying-out-of-pocket, there are private online companies providing telehealth services, such as TeleDoc or Doctors on Demand. These services are better for more acute, general problems (e.g., symptoms of a urinary tract infection) rather than the management of chronic health issues related to PD.

Once your telehealth appointment is scheduled, you will want to prepare yourself to get the most out of your virtual visit.

Some good preparatory steps to take include:

  • Set up the telehealth platform on your laptop, tablet, or smartphone (your healthcare provider's office will provide this once your appointment is scheduled).
  • If you will be video conferencing, make sure you have a strong Internet connection and test your device's microphone and camera before your appointment.
  • Designate a quiet, well-lit room to have your telehealth visit in.
  • Ask a loved one or arrange for a sitter to provide child or pet care during the time of your visit.
  • If applicable, fill out a symptom diary or any electronic assessments provided by your provider beforehand (these may be used to help guide the virtual appointment).
  • Jot down notes and questions related to the symptom or health problem you will address with your provider.
  • Fill out and return any paperwork or online consent forms required for telehealth.

On the day of your appointment, you will also want to:

  • Ensure your device is fully charged.
  • Wear loose-fitted comfortable clothes and shoes. You may be asked to perform certain physical maneuvers during the session.
  • Arrange for a plan in case there is a technical glitch. For example, a family member or care partner may be present (with consent) to assist you, or you may consider setting up a second device in the event the first device fails.

What Happens During the Visit

At the start of the visit, you may be asked to give verbal or online consent for virtual care. Your healthcare provider will engage in your telehealth visit in much the same way as a regular in-person visit.

For instance, if you are seeing your neurologist for a regular check-up, you can expect them to greet you, followed by reviewing your medications and recent laboratory or imaging tests.

Before addressing your specific concerns, your neurologist will probably ask you about common PD symptoms like falls and whether you are experiencing any sleep or mood problems. Also, they will probably inquire into how well you can perform your activities of daily living.

Examples questions may include:

  • Do you need to be accompanied on all shopping trips, or are you able to shop independently for small purchases?
  • Are you able to take your medication on your own at the correct dosage at the correct time? Do you use a pillbox or dispenser?
  • Are you able to perform light household chores like dishwashing or making your bed?

While your doctor cannot perform a comprehensive neurological exam themselves, they may ask you to perform various physical maneuvers such as tapping your index finger on your thumb as fast as possible or standing up from your chair without using your hands.

Based on the outcome of your visit, your doctor may electronically prescribe a new medication, refill an old medication, or some combination. Prescriptions for imaging tests and bloodwork and/or a referral to a form of rehabilitation therapy (e.g., speech, physical, occupational) may also be performed during your virtual visit.

Regular follow-up is key to optimizing your PD care. With that, once your telehealth visit is over, be sure to clarify with your doctor when your next follow-up is and whether that visit should be in-person or virtual.

A Word From Verywell

For people with Parkinson's disease, telehealth offers a valuable and feasible way of obtaining care without the hassle of driving and the risk of falling or being exposed to the COVID-19 virus. Besides convenience and safety, telehealth also allows patients to "see" their provider from the comfort of their own bed, desk chair, or couch.

With the emergence and success of telehealth during the COVID-19 pandemic, it's likely that this virtual service will become a normal part of healthcare delivery. For most, this prospect is truly exciting—and the potential for expansion (e.g., telehealth support groups or exercise programs) is endless.

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  1. Korn RE, Shukla AW, Katz M et al. Virtual visits for Parkinson's disease. Neurol Clin Pract. 2017;7(4):283–295. doi:10.1212/CPJ.0000000000000371

  2. Miele G, Straccia G, Moccia M, et al. Telemedicine in Parkinson's disease: How to ensure patient needs and continuity of care at the time of COVID-19 pandemic. Telemed J E Health. 2020;26(12):1533-1536. doi:10.1089/tmj.2020.0184