Increasing Access to Specialty Care: A Pilot, Randomized Controlled Trial of Telemedicine for Parkinson’s Disease E. Ray Dorsey, MD, MBA, 1 * Lisa M. Deuel, BA, 1 Tiffini S. Voss, MD, 2 Kara Finnigan, PhD, 3 Benjamin P. George, BS, 4 Sheelah Eason, MSW, 1 David Miller, 5 Jason I. Reminick, MS, 4,6 Anna Appler, RN, 7 Joyce Polanowicz, RN, 7 Lucy Viti, RN, 7 Sandy Smith, BS, 7 Anthony Joseph, MSW, MPA, 7 and Kevin M. Biglan, MD, MPH 1 1 Department of Neurology, University of Rochester Medical Center, Rochester, New York, USA 2 Department of Neurology, University of Virginia Health System, Charlottesville, Virginia, USA 3 Warner School of Education, University of Rochester, Rochester, New York, USA 4 School of Medicine and Dentistry, University of Rochester, Rochester, New York, USA 5 Clinical Trials Coordination Center, University of Rochester Medical Center, Rochester, New York, USA 6 Simon School of Business, University of Rochester, Rochester, New York, USA 7 Presbyterian Homes and Services, Inc., New Hartford, New York, USA Video Abstract: We conducted a randomized, controlled pilot trial to evaluate the feasibility of providing subspecialty care via telemedicine for patients with Parkinson’s disease residing in a remote community located 130 miles from an academic movement disorders clinic. Study participants were randomized to receive telemedicine care with a movement disorder specialist at the University of Roches- ter or to receive their usual care. Participants in the tele- medicine group received three telemedicine visits over six months. Feasibility, as measured by the completion of tele- medicine visits, was the primary outcome measure. Sec- ondary measures were quality of life, patient satisfaction, and clinical outcomes. Ten participants residing in the community were randomized to receive telemedicine care (n 5 6) or their usual care (n 5 4). Four nursing home patients were assigned to telemedicine. Those receiving telemedicine completed 97% (29 of 30) of their telemedi- cine visits as scheduled. At the study’s conclusion, 13 of 14 study participants opted to receive specialty care via telemedicine. Compared with usual care, those randomized to telemedicine had significant improvements in quality of life (3.4 point improvement vs. 10.3 point worsening on the Parkinson’s Disease Questionnaire 39; P 5 0.04) and motor performance (0.3 point improvement vs. 6.5 point worsening on the Unified Parkinson’s Disease Rating Scale, motor subscale; P 5 0.03). Relative to baseline, nursing home patients experienced trends toward improve- ment in quality of life and patient satisfaction. Providing subspecialty care via telemedicine for individuals with Par- kinson’s disease living remotely is feasible. Ó 2010 Movement Disorder Society Key words: Parkinson’s disease; telemedicine; clinical trials Telemedicine increases access to specialty care, 1,2 especially for individuals residing outside urban cen- ters. Investigations of telemedicine for Parkinson’s dis- ease (PD) have shown that telemedicine is an accepta- ble means of care delivery, reduces travel burdens, and may improve patient outcomes. 3–5 However, these studies were not randomized or controlled and did not specifically include nursing home patients, who may benefit the most from specialty care. 6 We, therefore, conducted a pilot, randomized, controlled feasibility Potential conflict of interest: Nothing to report. Additional Supporting Information may be found in the online version of this article. *Correspondence to: E. Ray Dorsey, University of Rochester, 1351 Mount Hope Avenue, Suite 223, Rochester, NY 14620 E-mail: ray.dorsey@ctcc.rochester.edu Received 18 September 2009; Revised 1 February 2010; Accepted 15 March 2010 Published online 8 June 2010 in Wiley InterScience (www. interscience.wiley.com). DOI: 10.1002/mds.23145 1652 Movement Disorders Vol. 25, No. 11, 2010, pp. 1652–1659 Ó 2010 Movement Disorder Society