Access to Care for Patients with Epilepsy During COVID19
Recent CMS actions will make it easier for patients suffering from seizures or seizure-like disorders to access care during the COVID-19 pandemic.
On March 13, 2020, CMS expanded Medicare’s telehealth benefits under the 1135 waiver authority and the Coronavirus Preparedness and Response Supplemental Appropriations Act. This waiver and other recent actions by CMS provided flexibility to allow Medicare beneficiaries, particularly high-risk individuals, to receive various services through telehealth. Medicare beneficiaries are now able to visit with their doctor from their home, without having to go to a doctor’s office or hospital. Such access was previously restricted by diagnoses and the severity of disease to a limited number of patients – now it is available to everyone. Telemedicine services for epilepsy patients reduce their need to visit hospitals and clinics where they are at higher risk for disease exposure during the pandemic. A secondary benefit is that the clinical resources needed for these visits can be redeployed by healthcare systems already under significant strain from COVID-19.
With respect to patients suffering from epilepsy, another impact of the pandemic is on the availability of inpatient diagnostic services. Hospital resource demands combined with concerns about patient exposure to the disease have led the majority of Epilepsy Monitoring Units (EMUs) to halt all elective admissions and, in some cases, cease operations altogether. Without alternatives, a physician’s ability to obtain the correct diagnosis and prescribe optimal therapy will become increasingly difficult in this patient population. The likely result will paradoxically be increased emergency department visits and hospitalizations. For appropriate patients, one viable alternative is in-home (ambulatory) video EEG monitoring (AVEEG). Numerous studies in peer-reviewed journals support AVEEG as both a clinically and cost-effective diagnostic tool – one which during the current crisis can be part of the solution.
We at Stratus stand ready to assist as needed – by providing support in the form of registered EEG technologists for remote monitoring (for healthcare systems suffering from the shortage of trained personnel) or performing in-home video EEG monitoring for patients whose inpatient studies have been unavoidably delayed.
Stratus d/b/a Alliance Neurodiagnostics, LLC, is accredited by the Joint Commission, and like hospitals, adheres to strict patient safety and quality standards. During this pandemic, we have also adopted CDC published guidelines for elevated precautionary measures for healthcare professionals who engage in patient care. We have implemented the following protocols:
- Technologists are equipped with proper contact, droplet, and airborne protective equipment, and will follow CDC advanced protocols when interacting with patients. Our technologists have been trained in these protocols and rehearsed for this scenario.
- We will continue our diligence to ensure all environmental cleaning and disinfection procedures are followed consistently and correctly. Per Joint Commission Standards, we use hospital-grade, EPA-registered disinfectants. In addition, we will continue to use disposable electrodes, single-use EEG recorder carrying cases, and batteries.
- Prior to any home visit, we will ensure our EEG technologist and patient have not been in close contact with someone with COVID-19, traveled to CDC identified “high risk” countries in the past 30 days, or have a fever or known infection. If they do, we will require they receive proper treatment and clearance from a qualified healthcare professional before returning to work or making an appointment.
Working with hospitals, clinics, physicians, and payors across the country, Stratus is working to maintain critical access for patients suffering from epilepsy during this challenging time.
About the Author
Jeremy Slater, M.D., has worked in the field of epilepsy for more than 27 years and currently serves as the Chief Medical Officer for Stratus. He served as the director of the Texas Comprehensive Epilepsy Program from 2004 through 2017, growing the center from a single neurologist and neurosurgeon to one of the largest epilepsy surgery programs in the country. Dr. Slater earned his medical degree at the University of Pittsburgh School of Medicine, in Pittsburgh, PA. He completed his residency in neurology followed by a fellowship in epilepsy and clinical neurophysiology at the University of Miami School of Medicine in Miami, FL.