Clinician Perspectives on Remote Monitoring for Patients with Headache Disorders
Aarti Katara1, Naomi Lebowitz1, Alexis George1, Jane Ekhtman1, Ramisha Aymon1, Ishah Yusaf1, Khushalee Oza1, Ivy Snyder2, Mia Minen1
1Neurology, NYU Langone Health, 2Ferkauf Graduate School of Psychology, Yeshiva University
Objective:

We assessed headache providers’ viewpoints on the potential for remote access to patients’ headache data and its practical utilization.  

Background:
With the ubiquitous nature of electronic medical records (EMR) and the existence of remote monitoring (RM) for many medical conditions, there is now potential for RM data for patients with headache disorders. While patients are asked to utilize headache diaries, clinicians may or may not have access to the data and the time to review it prior to patient visits, and their perspectives regarding this emerging technology are currently unknown. 
Design/Methods:

We conducted semi-structured virtual interviews with 20 headache providers, transcribed them and conducted qualitative analysis using grounded theory. 

 

Results:

All providers felt that the RM data would need to be integrated into the EMR. In speaking with them, six themes emerged: (1) Clinician Perspectives on how RM could be beneficial but at other times could create obstacles/challenges (subthemes: Clinician Obstacles, Clinician use of RM for visits, Concern for Data Accuracy), (2) How operationally it could benefit Headache Care (subthemes: Efficiency, Visit Time, Improvement  in Clinical Care, Patient Satisfaction), (3) Initial Logistics of Bringing RM into clinical practice (subthemes: The institutions themselves, the IT department, Privacy/Security, Integration into the EMR, data readability and visualization), (4) Considerations for education to be provided to both patients and clinicians, (5) How RM could be useful in research, and (6) Additional suggestions for considering the potential integration of RM into practice. 

Conclusions:
While headache providers had mixed opinions on the benefits/challenges of RM in Neurological care, patient satisfaction, and visit time, new ideas emerged that may advance clinical RM. Specifically, RM may capture headache pattern nuances, allow assessment of medication adherence and efficacy, and/or improve coordination of care across headache providers. 
10.1212/WNL.0000000000202859