What a video visit can accomplish
More than most patients expect. A movement disorders neurologist can take a full history, review medications in detail, watch you write, draw a spiral, hold a posture and use your hands, and review imaging uploaded in advance. For many patients this is enough to determine whether an advanced therapy is worth pursuing and which one is the likelier fit.
It is also often enough to identify the patients for whom the answer is no — because the diagnosis differs from what was assumed, because medication has not yet been optimized, or because the symptom causing the most difficulty is one that neuromodulation does not treat.
What still has to happen in person
A detailed neurological examination, a levodopa challenge, neuropsychological testing, imaging and the procedure itself all require you to be here. Surgery and focused ultrasound treatment are performed on site, and the visits immediately surrounding them are in person.
The practical effect is that remote evaluation compresses travel rather than eliminating it. Instead of several trips, most out-of-town patients make a small number of purposeful ones.
Follow-up from home
After treatment the balance shifts again. Focused ultrasound requires no device management, so much of the follow-up can be handled by video or by your local neurologist, with the RUSH team available for questions.
DBS has traditionally required repeated in-person programming visits, particularly in the first year. Some current systems support remote programming, where adjustments are made through a secure telemedicine connection. This does not replace in-person neurological assessment, but for patients living far from Chicago it can substantially reduce how often the journey is necessary. Availability depends on the device implanted and on the clinical situation.
What you need to join
A smartphone, tablet or computer with a camera and a stable internet connection. It helps to have good lighting, room to stand and take a few steps if asked, pen and paper to hand, and your medication bottles nearby. A family member present is usually worth arranging.
Licensing and insurance
Telemedicine is governed by state licensing rules and by your insurance plan, so what is possible depends partly on where you live. Our coordinators confirm before your appointment whether a video visit is available in your state and how it will be billed. See insurance and coverage for more.