Distance Travelled by patient for appointment with the Movement disorder clinic at Kentucky Neuroscience Institute – how to solve the problem?
Sindhura Tadisetty1, Prasanna Gangishetti1, Tarek Ali2, Zain Guduru1, Julie Gurwell1, John Slevin1, Tritia Yamasaki1
1University of Kentucky, 2University of Kentucky College of Medicine
Objective:
  1. 1)Calculate the distance traveled by patient to see a Movement disorder specialist at Kentucky Neuroscience Institute (KNI). 

  1. 2)Propose solutions to overcome long distances traveled by patients.

Background:
Movement Disorders is a specialized field in Neurology with few physicians dealing with conditions such as Parkinson's disease, Huntington’s disease etc. The Movement Disorders clinic at the University of Kentucky is staffed by four medical specialists and two advanced practice providers. Patients seen in this clinic come from all over the Commonwealth of Kentucky and surrounding states of Tennessee, Virginia, West Virginia, and Ohio.  
Design/Methods:
We used Epic slicer dicer to collect non-identifying details of 3509 patients seen by the Movement Disorders team at the KNI clinic between 10/8/2021 and 10/8/2022. 
Results:
We identified 352 unique Zip codes out of which 324 were in state. Using Google maps, we determined the distance travelled ranged from 0 miles to 661 miles; with an average of 115.5 miles. We identified 212 Zip codes, and 2064 patients from medically underserved areas according to the Health Professional Shortage Area (HPSA) Score given by the Health Resources & Services Administration of USA. The average distance traveled by patients from underserved areas was 100.98 miles.  
Conclusions:
Patients travel great distances to see Movement Disorders specialists. Visit frequencies range between 3 to 6 months. Sometimes it can be even more frequent for medication adjustments. The Covid-19 pandemic has shown us the advantage of Telehealth appointments. It is essential for Movement Disorders specialists to see patients in person to perform some aspects of the examination. However, based on the long distances traveled, we advocate for those appointments not requiring in-person examinations to be transitioned to Telehealth. We believe this will lead to better follow-up care through fewer missed or canceled appointments. 
10.1212/WNL.0000000000203260