We used an encrypted virtual video platform that provided confidentiality and privacy.  Before the virtual research visit, a test visit was completed to familiarize subjects with remote research processes.  Instructions on using the platform were sent ahead of time, including a study team contact telephone number in case problems arose during connecting.  

Test visit activities included assessment of audio/video quality and evaluation of the home study site.  A quiet space, free of distractions and interruptions in the subject’s home was selected with sufficient lighting and appropriate space and positioning for assessment.  Seating position was optimized to enhance the examiner’s view of the subject’s face and body, as body language could be missed over video. 

For the research visit, eConsent was obtained utilizing REDCap, a secure, HIPAA-compliant web-application which allowed for synchronous consent review and sign off.  Study team members were scheduled to join at certain times or kept in a virtual “waiting room” until they were needed to reduce visit disruptions.  Some subjects opted to complete portions of the visit at different times of the day.

In the 6 months since the beginning of pandemic restriction, we have completed 24 virtual study visits across two research protocols. Virtual visit activities have included neurologic exam, neuropsychological assessment, and administration of a disease-specific rating scale. Future goals include use of wearable devices and biometric assessments in the home environment.

Virtual visits are a feasible way to continue to engage subjects when travel is impossible.