In this article:
- Swedish is home to some of the nation's best and most advanced care for patients with multiple sclerosis.
- For patients who live in rural areas, accessing care can be difficult because of the challenges and costs of travel.
- Swedish Neuroscience Center's MS Center team began offering virtual visits during the pandemic.
- A Swedish MS expert shares how telehealth services for MS patients have been a gamechanger for patients and caregivers.
The expansion of telehealth since the COVID-19 pandemic has made it more convenient for everyone to see a doctor or specialist, but it has especially changed the lives of patients who have a chronic disease and live in rural areas.
“In Washington State, there are maybe just 20 multiple sclerosis (MS) specialists serving a population of somewhere between 7,000 to 14,000 people with MS,” says Pavle Repovic, M.D., neurologist and medical director for neurology research at the Swedish Multiple Sclerosis Center at the Swedish Neuroscience Institute.
MS is a neurologic disease that attacks the brain and spinal cord. Its symptoms are widely varied and present differently at different times; in some patients the disease causes the loss of ability to walk or move independently, while others may experience vision problems, vertigo, slurred speech, cognitive issues, and more. It is the leading non-trauma related cause of disability among people younger than 40 in the United States. MS doesn’t have a cure, but symptoms can be managed with therapy and medical care, and some people experience long periods of remission.
Because of the physical toll of the disease, traveling from a rural area to a physician appointment can be physically and mentally exhausting. This doesn’t even include the time and cost of traveling.
“Not everybody can travel to Seattle to access these specialists,” Dr. Repovic says. “It’s been a dream come true to bring this level of care to communities and treat patients without requiring them to come see us in the clinic for every visit.”
Physicians see MS patients at least once a year to look for subtle changes that may indicate a change in the disease. This makes virtual visits a great supplement, but not a full replacement, for in-person visits. Virtual visits can be an asset in addressing things like medication side effects or talking with psychiatrists and psychologists about mood changes and mental health concerns.
A change for the better
Before the pandemic, insurance companies were hesitant to pay for virtual medical visits in the same way they paid for in-person visits. This changed as the pandemic stretched on patients continued to access telehealth and virtual services. All visits were covered the same way. This meant that patients from rural areas could see Dr. Repovic or other MS caregivers no matter where they lived. He began seeing patients virtually from Washington, Alaska, Oregon, Idaho and Montana.
With the rollback of pandemic-related service changes, some previous requirements were reinstated. In Washington, for example, physicians can still see Washington residents virtually through telehealth appointments, while patients from Idaho or Montana may not be able to continue virtually seeing a physician from out of state. However, Alaska has ensured that patients can continue to use virtual medical appointments, even if their physician is out of state. “Our Alaska patients can continue seeing us without the two-day ordeal of flying to Seattle,” Dr. Repovic says.
The current care landscape
All new MS patients need to be seen in-person at first, as has always been the case, to help determine their personal baseline and disease progression. Follow-up appointments can be in-person or virtual, with varying frequency, depending on how a patient is doing.
“Many patients are in stable “cruise-control mode” with check-ins every six months,” Dr. Repovic says. Up to half of these visits might be virtual.
Physicians see MS patients at least once a year to look for subtle changes that may indicate a change in the disease. This makes virtual visits a great supplement, but not a full replacement, for in-person visits. Virtual visits can be an asset in addressing things like medication side effects or talking with psychiatrists and psychologists about mood changes and mental health concerns.
In addition to the very real medical concerns that come with MS, the Swedish Multiple Sclerosis Center works with patients through in-person activities in their Adventure and Recreation Program like skiing and kayaking, with virtual-reality options for those who need them.
The future starts now
New technology and tools are already helping monitor MS patients between medical appointments. For example, a new app, Floodlight MS, helps patients self-administer tests that gauge coordination and cognitive speed. The app stores test results and graphs them overtime, showing the patient and their physician trends.
“It’s a wonderful idea to help us as clinicians and help patients keep track of MS and what’s going on from week to week. MS is a silent siege, and can take things away slowly,” Dr. Repovic says.
“You don’t always notice little changes, and information can potentially help fill in that information gap by systematically capturing changes between visits. This is one more way technology is helping increase access to care and improve life for MS patients.”
Learn more and find a provider
If you have questions about multiple sclerosis, contact the Swedish MS Center. We can accommodate both in-person and virtual visits. Learn more about the Swedish Neuroscience Institute.
Whether you require an in-person visit or want to consult a doctor virtually, you have options. Contact Swedish Primary Care to schedule an appointment with a primary care practitioner. You can also connect virtually with your doctor to review your symptoms, provide instruction and follow up as needed. And with Swedish ExpressCare Virtual you can receive treatment in minutes for common conditions such as colds, flu, urinary tract infections, and more. You can also use our provider directory to find a specialist or primary care physician near you.
Information for patients and visitors
Related resources
Upcoming studies give hope to people with lupus and MS
MS treatment at Swedish: visionary research and world-class care
Watch videos: Learn how Swedish's MS Center Adventure Program fosters joy and community
CAR-T cell therapy: A promising and innovative treatment
This information is not intended as a substitute for professional medical care. Always follow your health care professional’s instructions.
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