Solution Description

Title
Your Name:
Subject and Section:
Professor’s Name:
Date Submitted:
Solution Description
This intervention will improve the accessibility of multidisciplinary quality care given to ALS patients. In this research, telemedicine's effectiveness as an intervention in monitoring and managing ALS will be studied, specifically regarding patient monitoring, symptom management, and disease progression.
In aiming for a patient-centered, multidisciplinary approach for ALS, the telemedicine for ALS will involve the following: subjective reporting, weight monitoring, and Revised Amyotrophic Lateral Sclerosis Rating Scale (ALSFRS-r), as done in the research studies of Wills, Garry, Hubbard, et al., (2019) and Capozzo, Zoccolella, Musio, et al., (2020) involving telemedicine and remote ALS management. This will be executed through apps, calls, and video conferencing as proposed in the user-centered program of Hobson, Baird, Partridge, et al. (2018).
Selkirk, Washington, McClellan, et al. (2017) conducted a similar study to improve the specialized care that ALS requires. This set of assessments effectively monitors disease progression using the ALSFRS-r as an instrument to check the progression in ALS-caused impairments and disabilities.
Feasibility of intervention
In the study of Helleman, Van Eenennaam, Kruitwagen, et al. (2020), telemedicine's feasibility to provide health care services for ALS patients was demonstrated. Previous studies' barriers and limitations include lack of access to a stable internet connection, unavailable gadgets, and exclusion from insurance coverage.
In the study of Helleman, Eenennaam, Kruitwagen, et al. (2020), the patient or caregiver's training can conduct the assessments with proper supervision from a licensed physician or ALS registered nurse ensure objectivity and accuracy of the assessments. In addition to this, the ALSFRS-r is also a validated instrument that is self-administered.
A limitation of telemedicine as a multidisciplinary and regular part of an ALS patient is the cost (Andrews et al., 2020). Although telemedicine is promoted to be cost-effective and efficient in providing multidisciplinary care, telemedicine's exclusion in the insurance coverage of patients poses as a barrier to health care.
Consistency with culture
The study setting will be at the University of Chicago Hospital, a known ALS clinic that offers multidisciplinary care for ALS patients. The team involved in providing holistic quality care to the patients includes neurologists, surgeons, cardiologists, pulmonologists, geneticists, orthotists, nurses, and social workers.
Expected outcomes: P
The population will be patients diagnosed with ALS who are needing multidisciplinary care for ALS monitoring and management. It will also be noted whether the patient will be doing the telemedicine or if a caregiver will assist it.
Expected outcomes: I
In telemedicine, a multidisciplinary team of specialists will conduct remote health consultations. This will be done through video conferencing, voice calls, and applications with the help of a multidisciplinary team for ALS.
Expected outcomes: C
The face-to-face consultations will be the comparison group in the study. The routine assessments will be done in the University of Chicago Hospital by a team of ALS specialists.
Expected outcomes:O
In telemedicine, the disease progression is the primary outcome to be monitored, using a validated instrument specialized for ALS patients, the ALSFRS-r, which is done once a month (Rooney et al., 2017). The minor outcomes that will be included in the study are nutritional status, cognitive function, psychological status, and frequency of hospitalizations. The same outcomes will be used for both face-to-face and telemedicine consultations.
Methods: Quality Care
The quality of care will be ensured by giving standardized tests and having the same set of medical staff who are licensed and skilled in their own ALS specializations.
Methods: Processes
The ALSFRS-r is a tool that measures speech, salivation, swallowing, handwriting, nutrition intake, handling food and utensils, hygiene and dressing, med mobility, ambulation, stair negotiation, orthopnea, dyspnea, and respiratory insufficiency did once a month (Rooney et al., 2017). The minor outcomes will be monitored using the following methods: Weighing once a week will monitor the patient's nutritional status with ALS. This can also be used to detect a need for hospitalization in cases of sudden weight loss. The checking of the patients' cognitive and psychological status will be assessed through subjective input and video conferences with specialists on the field.
Methods: Professional expertise
<...