A New Vision in Headache Medicine: A Survey of Headache Specialists’ Utilization of Telehealth in Their Practice (2444)

Objective: To assess the practice of telehealth for headache visits in the US. Background: The rapid roll-out of telehealth during the covid-19 pandemic impacted headache specialists. Design/Methods: American Headache Society (AHS) members were emailed an anonymous survey (9/9/20–10/12/20) to complete if they had logged ≥2 months or 50+ headache visits via telehealth. Results: 225 of 1348 (16.7%) AHS members responded. Most were female (59.8%; 113/189). Mean age was 47.4±11.8 (N=154). The vast majority were MD/DOs (83.2%;158/190) and NP/PAs (14.7%; 28/190), and most (65.1%; 123/189) were in academia. Years in practice were: 0–3: 28; 4–10: 58; 11–20: 42; 20+: 61. Mean number of telehealth visits was 199.4 ± 214.8 in prior 3 months. Respondents were “comfortable” or “very comfortable” treating via telehealth a (a) new patient with a chief complaint of headache (137/185); (b) follow-up for migraine (184/186); (c) follow-up for secondary headache (116/182). About half (51.1%; 97/190) offer urgent telehealth. Beyond being unable to perform in-person procedures, top barriers cited were conducting parts of the neurologic exam (157/189), absence of vital signs (116/189), and socio-economic/technologic barriers (88/189). The top positive attributes were patient convenience (185/190), reducing patient travel stress (172/190), patient cost reduction (151/190), flexibility with personal matters (128/190), patient comfort at home (114/190), and patient medications nearby(103/190). Only 20% (31/155) of providers said that telehealth visit length differed compared to in person visits and 55.3% (105/190) believe the no-show rate improved. Providers were “interested”/”very interested” (128/188) in digitally prescribing headache apps and “interested”/”very interested” (121/189) in the remote monitoring of patient symptoms. Conclusions: Respondents were comfortable treating migraine patients via telehealth They note positive attributes for patients and how access to care may be improved. Technology innovations (remote vital signs, digitally prescribing headache apps) and remote symptom monitoring are areas of interest for headache specialists and warrant future research. Disclosure: Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Pain Medicine Journal. The institution of Dr. Minen has received research support from Doris Duke Fellowship to Retain Clinician Scientists. The institution of Dr. Minen has received research support from NIH. Dr. Minen has received intellectual property interests from a discovery or technology relating to health care. Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a First Contact-Primary Care Advisory Board Member with American Headache Society . Dr. Minen has received personal compensation in the range of $500-$4,999 for serving as a Consultant for PCORI grant on migraine evidence based map for stakeholders with ECRI. Dr. Minen has received personal compensation in the range of $0-$499 for serving as a consultant for ICER report with ICER. Dr. Strauss has a non-compensated relationship as a Secretary with Southern Headache Society that is relevant to AAN interests or activities. Kayla Kaplan has nothing to disclose. Ms. Ehrlich has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Impel Neuropharma. Ms. Ehrlich has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Currax. Ms. Ehrlich has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Eli Lilly. Ms. Ehrlich has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Allergan. Ms. Ehrlich has received personal compensation in the range of $5,000-$9,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of the Pacific. Ms. Ehrlich has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Copple Law Firm. Ms. Ehrlich has a non-compensated relationship as a Working Group Member with Alliance for Patient Access that is relevant to AAN interests or activities. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Allergan / AbbVie. Dr. Bennett has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Amgen. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Teva. Dr. Bennett has received personal compensation in the range of $50,000-$99,999 for serving on a Speakers Bureau for Allergan / Abbvie. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Amgen. Dr. Bennett has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Teva. Dr. Bennett has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biohaven. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving as a Consultant for nestle. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Biohaven. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Xoc Pharma. Dr. Rizzoli has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Headache Cooperative of New England. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Harvard Health Publishing. Dr. Rizzoli has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for CVS. The institution of Dr. Rizzoli has received research support from Allergan. The institution of Dr. Rizzoli has received research support from Eli Lily . Dr. Rizzoli has received publishing royalties from a publication relating to health care. Dr. Riggins has received personal compensation in the range of $500-$4,999 for serving as a Consultant for GLG Gerson Lehrman Group . The institution of Dr. Riggins has received research support from ElectroCore (GammaCore). The institution of Dr. Riggins has received research support from Miles for Migraine.