Catching and counting seizures for patients with epilepsy using an automated telemedicine platform - EpxEpilepsy (P1.247)

Objective: We undertook the design and implementation of a proactive telecommunication tool, EpxEpilepsy, to more accurately and frequently track seizures, thereby improving the care of epilepsy patients. Additionally, we present a cost-benefit analysis that demonstrates its capability to enable new revenue generation for providers under recent fee-for-service codes. Background: To fill in the gaps between often long periods between clinic visits, epilepsy management revolves around self-recorded seizure diaries, which can be inaccurate and incomplete. Tracking seizures with high temporal resolution is critical for medication titration, which is key to reducing the time to seizure freedom. Design/Methods: EpxEpilepsy is an automated service that uses text messages and phone communications to ask patients about seizure events. Responses are tracked and summarized for the provider both in text and graphical formats with alerts notifying the provider of high-risk individuals. 9 patients from the Washington University Epilepsy Center with a diagnosis of epilepsy were enrolled. Patients received one text message every week for 12 weeks. After the initial 4 weeks, patients were interviewed to understand their experience using EpxEpilepsy. The goal of the pilot study was to track response rates, message fatigue, the percentage of patients who reported seizure activity, and the number of seizures that could be detected by the system. Results: We achieved a 74.1% response rate (95% confidence interval ±8.38%) and detected 180 seizures, with a third of our patients at a 100% response rate. Conclusions: While the study suffers from a small sample size and a nonrandomized uncontrolled design, our data suggests that EpxEpilepsy provides a promising platform for proactive seizure tracking in epilepsy patients. As such, a randomized control trial is ongoing with a larger sample size examining EpxEpilepsy’s effect on time to seizure freedom. Disclosure: Dr. Zhang has nothing to disclose. Dr. Chen has nothing to disclose. Dr. Javaherian has nothing to disclose. Dr. Groenendyk has nothing to disclose. Dr. Pan has nothing to disclose. Dr. Maccotta has nothing to disclose.