title: Implementation of an Integrative Holistic Healthcare Model for People Living with Parkinson's Disease.
abstract: OBJECTIVE
  Research demonstrates that people with Parkinson's disease (PD) benefit greatly from multidisciplinary medical care. Delaware does not have a Movement Disorder Center or a movement disorder specialist. To address this issue, the University of Delaware Nurse Managed Health Center (NMHC) developed a novel PD Telehealth Clinic serving individuals with PD and their caregivers throughout Delaware.
  
  
  METHODS
  The PD clinic is based on a collaborative framework that uses synchronous videoconferencing telehealth technology to bring together out-of-state clinicians and scientists with expertise in PD to help deliver specialized care to PD patients and their caregivers. The team includes a movement disorder specialist, psychologists, nurse practitioners, researchers, physical and speech therapists, exercise physiologists, nutritionists, and graduate students. The PD Clinic delivery model seamlessly blends telehealth provider and onsite provider interactions, enabling the diagnosis, treatment, and ongoing management of PD.
  
  
  RESULTS
  In the first 6 months of the Parkinson's clinic opening, the nurse practitioners along with the movement disorder specialist evaluated 36 PD patients. Several patients have received recommendations to change their medication regimen by the movement disorder specialist. About 20 patients were referred to physical therapy, 7 to speech therapy, 9 to mental health services, 1 to occupational therapy, and 12 to local support groups. The location of the NMHC-PD clinic has reduced travel time and distance by as much as 1.5 hr or 80 miles, each way, and wait time for a new patient appointment is less than 3 months.
  
  
  CONCLUSIONS
  The NMHC - PD Telehealth Clinic provides access to specialized multidisciplinary and advanced care and was successfully implemented. This model can be replicated in other nurse managed health centers across the United States.
authors.affiliation: School of Nursing, University of Delaware, Newark. iaboff@udel.edu.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Pretzer-Aboff
authors.affiliation: Nurse Managed Health Center, University of Delaware, Newark.
authors.forename: Allen
authors.initials: A
authors.lastname: Prettyman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D005260:Female; D006297:Health Services Accessibility; D018939:Holistic Nursing; D006801:Humans; D055048:Integrative Medicine / Q000379:methods*; D009726:Nurses; D017063:Outcome Assessment, Health Care; D010300:Parkinson Disease / Q000534:rehabilitation*; D010348:Patient Care Team; D017060:Patient Satisfaction; D012657:Self-Help Groups; D017216:Telemedicine / Q000458:organization & administration*; D014481:United States; D049269:Videoconferencing
keywords: Holistic; Integrative; Parkinson’s disease; Telehealth; Telemedicine