Objective: To describe the feasibility and utility of the Asynchronous Consultation for Movement Disorders (ACMD) program. ACMD coordinates telehealth consultations between movement disorder specialists (MDS) and local physicians (LP) in Africa to increase access to specialty care.

Background: Parkinson’s disease (PD) and other movement disorders are globally prevalent, but access to MDS is limited in under-resourced areas. Asynchronous telemedicine consultations aim to overcome the difficulties attributed to geographic barriers and real-time consults.

Methods: In this program, LP use a secure app to send materials to the ACMD project manager, including: 1) videos that follow a standardized neurological exam protocol; and 2) case reports that use the ACMD referral template. The ACMD project manager uploads the video and case report to a secure electronic medical record (EMR) system and assigns a consulting MDS to the case. The MDS writes a consultant report on the EMR that includes a diagnostic evaluation and treatment recommendations. A Telemedicine Satisfaction Survey is completed by both MDS and LP after the consult is completed.

Results: The ACMD program was launched in November 2015. As of October 2017, 43 individual consultation requests from LP in Tanzania, Nigeria, and South Africa have been submitted; 100% were completed as scheduled by 6 consultant movement disorders specialists. Telemedicine Satisfaction Surveys found that 100% of LP were either “satisfied” (20%) or “very satisfied” (80%) with the consultations provided. LP made changes to their evaluations and/or treatments based on recommendations made by consultants 80% of the time. MDS were similarly “very satisfied” or “satisfied” with the ability to provide the consults 94% of the time. The biggest challenge for both LP and MDS was difficulty uploading and downloading the video portion of the consultation. A survey of the African Academy of Neurology indicated that, of 59 members surveyed, 93% would like to participate in the ACMD program. As a result, we are extending the ACMD program to 5 more countries in Africa in 2018.

Conclusions: The ACMD program was feasible, with a high level of overall satisfaction expressed by referring providers and consultants. The consultations provided value from a clinical and educational perspective, enhancing access to specialty care in under-resourced areas.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/asynchronous-telehealth-consultations-for-movement-disorders-in-africa/