Objective: Improve patient and physician care delivery experience through a technology-driven coaching and triage system.

Background: Limited worldwide supply of Parkinson’s specialty care restricts access to advanced therapies and correlates with higher symptom burdens and worse healthcare outcomes [1]. Here we report on a pilot program to increase access to care in the context of a large integrated delivery system. The program employed wearables and a dedicated patient-facing app in addition to human centered workflows to monitor, triage and manage patient risk effectively, as well as provide on demand access to data to both patients and clinicians. We provide validation of objective data captured by the application in a large cohort of >1000 patients to aid in management and tracking of their disease.

Method: Parkinson’s patients with moderate severity (H&Y stage 2 & 3), bilateral symptoms and responsiveness to Levodopa were included in this pilot. Patients used a wearable paired to a mobile application to monitor their symptoms, receive medication reminders and access educational content. Patients were instructed to report specific high-risk symptoms prespecified by their clinicians, such as falls, rapid decline in mobility or hallucinations. Regular coaching sessions regarding mobile application usage, medication reminders and reporting were offered. Prior to upcoming visits with Movement Disorder Specialists (MDS), automated, AI-generated reports summarized passively and actively reported symptoms, and these reports were used as a tool to enrich communications during clinical visits.

Results: Patients showed high utilization of the program, with application engagement at least once per week, and >8 hours of passively collected data per day. Despite the moderate severity of disease across all pilot patients, we found highly variable patterns in reported high risk symptoms, as well as passively-monitored mobility, tremor and dyskinesia patterns. Patients reported value in the personalized reports and educational content, which increased confidence in disease management outside of clinician offices and boosted communications with clinicians during clinical visits.

Conclusion: This program has the potential to reduce burden on MDS clinicians, flag problematic symptoms sooner, support timely care plan changes between clinical visits and reduce hospitalization.

References: [1] Pearson, C., Hartzman, A., Munevar, D., Feeney, M., Dolhun, R., Todaro, V., Rosenfeld, S., Willis, A., & Beck, J. C. (2023). Care access and utilization among medicare beneficiaries living with Parkinson’s disease. NPJ Parkinson’s Disease, 9(1), 108.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/unlocking-movement-disorder-specialist-capacity-and-mitigating-risk-a-platform-solution-for-cost-reduction-and-care-optimization-in-parkinsons-disease/