Telehealth in Motor Neurone Disease TiM

TiM stands for Telehealth in Motor Neuron Disease. The TiM platform is a system hosted on the application, MyPathway, through which people living with MND, and their carers, can enter information about their condition on a weekly basis. Their answers are then available to their MND care team, who can make plans to support the person living with MND.

The need for remote monitoring and delivery of highly specialised care, away from a hospital setting, became vital to protect vulnerable MND patients when COVID-19 hit. Using Sheffield Teaching Hospital’s system TiM, which has been developed by leading digital healthcare company ADI, TiM on MyPathway enables the specialist MND service in Beaumont to monitor and manage their patients digitally. Three Ireland has come on board to support access to devices and internet connectivity where that is an issue, limiting patients accessing TiM.

MND Patients and caregivers often find traveling long distances to their appointments arduous, not only that but when they arrive at the clinic the waiting time can be considerable. Trinity College Dublin’s data indicated that prior to COVID-19 a large proportion of the patient’s time in the clinic (70%) was spent waiting for review by members of the multidisciplinary team, with only 30% of time spent in meaningful engagement with clinical professionals. Trinity College Dublin’s patient journey data also indicates that community-based clinical professionals have limited experience of MND, therefore patients and caregivers may struggle to access the expertise required between clinic visits and may receive advice that is not in keeping with best practice. All these problems have been considerably magnified by the recent COVID-19 pandemic.

TiM on MyPathway addresses the issues of restricted visits to clinics during COVID-19, the need to plan clinics in advance to minimise waiting times, and the need to communicate with services locally to ensure a standardized quality of care.  The platform allows patients and their caregivers to report their progress and symptoms from their homes using a remote digital application. Clinicians can remotely monitor their patients and are alerted to any concerns or changes in their condition. Information leaflets and resources developed by the Irish Motor Neurone Disease Association (IMNDA) are linked to the TiM system ensuring patients access reliable and useful information.

The ADAPT Centre sees the possibility of interoperability between TiM on MyPathway and the Patient Data Display Platform by building an API that allows the ingestion of data from the TiM on the MyPathway app. This data could be used to further enrich the knowledge graph and Patient Data Display Platform outputs. The ADAPT team has been working with Orla Hardiman and her team to develop an ontology and schema to accommodate data from a variety of different sources that can be uplifted to a knowledge graph. This data interrogation will be output through a variety of visualisations via a patient data display platform.  These outputs will allow the clinicians to view and assess a particular patient’s data or group of patients’ data utilising a range of data points and timelines.

Professor Orla Hardiman, Professor of Neurology, Trinity College Dublin, said: “This important telehealth project will meet the needs of vulnerable patients and families with a progressive neurologic disease whose care is compromised as a direct consequence of the disruption imposed by the COVID-19 pandemic. In the longer term, the work will help to address the considerable fragmentation of care in Ireland. We will have a sophisticated communication system between patient/caregivers and their health care professionals in hospital and community settings.”