Challenges and Trust in Telehealth Integration for Multiple Sclerosis Care: Enrique Alvarez, MD, PhD

WATCH TIME: 4 minutes

"As technology gets better, I think we’ll also have more stability in the measures. The challenge we really have in that regard is just knowing what the best measures are to look at. Technology can measure a lot of things, but what do we need to focus on?"

Telehealth has emerged as a vital tool in the management of multiple sclerosis (MS), offering patients enhanced access to care, especially during periods when in-person visits are challenging. However, its implementation presents several obstacles. Studies have identified that older age, lower socioeconomic status, and certain disease-related impairments may be associated with reduced access to and utilization of telehealth services among individuals with MS. These disparities can exacerbate existing healthcare inequities if not proactively addressed.¹ Additionally, healthcare providers have reported difficulties in interpreting remote examinations, communicating effectively with patients, and managing technical issues during telehealth sessions, highlighting the need for improved training and support for both patients and providers.²

As telehealth continues to play a larger role, the integration of device-based data collection into clinical practice presents its own set of challenges. Mobile and wearable technologies offer the potential for continuous monitoring of MS symptoms and progression, but several issues persist. Concerns around data quality, consistency, and patient privacy are prevalent, with the need for secure and accurate data collection being paramount for its acceptance and utility in clinical settings. Furthermore, the reporting burden on patients, particularly those with progressive forms of MS, is a significant factor. Careful consideration of study designs and data collection frequencies could be required to avoid participant fatigue and disengagement. Addressing these challenges may be essential for successfully integrating digital tools into MS care, ensuring enhanced patient outcomes without creating new barriers.

At the 2025 Americas Committee for Treatment and Research in Multiple Sclerosis (ACTRIMS) Forum, held February 27 to March 1, in West Palm Beach, Florida, Enrique Alvarez, MD, PhD, spoke in a symposium titled “Using Modern Tools and Frameworks to Reengineer Multiple Sclerosis Management.” During the event, Alvarez, a professor of neurology at the University of Colorado School of Medicine, discussed these ongoing challenges in telehealth, particularly with technology issues such as internet connectivity and device malfunctions. He also addressed the growing concerns about privacy and trust, especially as wearable devices and other technologies are increasingly used to monitor patient data. Alvarez emphasized the importance of transparent communication and establishing trust with patients to overcome these obstacles. He also underscored the need for careful consideration of which aspects of patient health to measure and how to analyze that data effectively.

Click here for coverage of 2025 ACTRIMS Forum.

REFERENCES
1. Marrie RA, Kosowan L, Cutter G, Fox R, Salter A. Disparities in Telehealth Care in Multiple Sclerosis. Neurol Clin Pract. 2022;12(3):223-233. doi:10.1212/CPJ.0000000000001167
2. Keszler P, Maloni H, Miles Z, Jin S, Wallin M. Telemedicine and Multiple Sclerosis: A Survey of Health Care Providers Before and During the COVID-19 Pandemic. Int J MS Care. 2022;24(6):266-270. doi:10.7224/1537-2073.2021-103
3. Krieger K, Nicholas J, Alvarez E. Time for a Reset: Using Modern Tools and Frameworks to Reengineer Multiple Sclerosis Management. Presented at ACTRIMS Forum 2025; February 27 to March 1; West Palm Beach, Florida. SS3.