Remote programming of DBS for movement disorders to be funded on Medicare

Movement disorders

By Michael Woodhead

21 Apr 2022

Prof Peter Silburn

A new MBS item is to be introduced in November 2022 that will fund remote programming of a neurostimulator for deep brain stimulation for the treatment of Parkinson’s disease, essential tremor and dystonia.

The new item, announced as a funding measure in the 2022 federal Budget, mirrors current MBS item 40862 but will allow the service to be performed remotely, providing more convenience and greater access for patients, according to neurologists with a special interest in movement disorders.

Professor Peter Silburn, a neurologist at the Queensland Brain Institute who has led trials of the remote control of DBS described it as “a huge leap forward in patient care.”

“This will allow more people access to DBS who can benefit from the therapy. For patients in rural areas, if a problem arises and they need to see their specialist, currently they may have to drive for several hours or organise a care flight which costs thousands of dollars,” he said.

“Being able to connect with their physician from home or while they are travelling gives patients independence and predictability, which is so important for quality of life,” he added.

“Patients will have the convenience of being treated in their own home, which is even more beneficial during pandemic restrictions. Patients and their families will also be able to travel with confidence, knowing that if they need to, they can still connect with their doctor from overseas and get the same highly personalised assessment and care they would at home.”

The technology would also free up time for neurologists and give them more flexibility in when and where to provide treatment, he added.

“Doctors will spend less time travelling between different locations to see their patients meaning they can help more people in a day, and not waste time stuck in traffic, for example. If a patient urgently needs adjustment when I’m out of town, I can see the patient in high-definition video, including their device parameters, literally from anywhere.”

The technology is being rolled out in Australia by Abbott, whose NeuroSphere Virtual Clinic is  launched at the end of 2021.

DBS is currently approved for use in movement disorders in Australia, including essential tremor. To be eligible for DBS, patients must undergo a comprehensive assessment process including psychological evaluation.

According to Abbott, the NeuroSphere Virtual Clinic is available as a free update to patients with an Abbott Infinity DBS system through participating clinical practices.

The company says its DBS devices come with a patient controller that connects via Bluetooth to the Implantable Pulse Generator (IPG), which is surgically placed in the patient’s upper chest and delivers pulses to the electrodes in the patient’s brain. The controller allows the patient to switch between programs set by their doctor for the desired therapeutic effect.

However, more complex adjustments that are needed for ongoing care, such as when the patient’s symptoms advance or change, is currently provided face to face in a clinic setting.

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