American Academy of Neurology Telehealth Position Statement

Abstract

Telehealth services complement in-person neurologic care. The American Academy of Neurology (AAN) supports patient access to telehealth services regardless of location; coverage for telehealth services by all subscriber benefits and insurance; equitable provider reimbursement; simplified state licensing requirements easing access to virtual care; and expanding telehealth research and quality initiatives. The roles and responsibilities of providers should be clearly delineated in telehealth service models.

Digital work engagement among Italian neurologists

“…Specific risks of access to private patient information and other cybersecurity issues, such as malware, ransomware attacks, or system breaches, should be carefully evaluated in the choice of telemedicine systems. 13 This could also apply to the widespread use of emails to communicate with patients and share clinical information, which are exposed to the risk of data breach. Specific online platforms, such as Microsoft Teams, Zoom, or Webex are considered more compliant with sharing sensitive information, and their use could be considered by healthcare organizations, at least in the USA, where they comply with the Health Insurance Portability and Accountability Act.…”

Neuroethics in the Era of Teleneurology

“…On the basis of this principle, implementation of teleneurology services might be viewed as ethically imperative insofar as teleneurology could enhance patient autono-my through enabling access to comprehensive evaluations for patients who might not have otherwise been able to receive neurological assessment in traditional office settings due to geographic barriers, resource constraints, or disability. [37][38][39] Championing the potential of teleneurology to enhance the autonomy of patients and caregivers, a 2021 American Academy of Neurology (AAN) Position Statement on Telehealth highlights the potential autonomy-promoting effects of teleneurology including "improving convenience and democratizing access to subspecialists throughout the nation… enhanced comfort, convenience and safety, particularly for patients with limited mobility due to their medical condition or need for home medical support equipment…reduced caregiver stress… decreased time away from work or other essential activities for patients and care partners; increased care partner and provider participation…better assessment of social determinants of health, including the patient's home environment…early intervention prior to a scheduled office visit, based on continuous assessment of neurological disease progression and treatment efficacy… [and] protection of patient and providers from infectious disease exposure and reducing use of personal protective equipment." 39 However, the AAN Position Statement also describes limitations of telehealth technologies.…”

Trends in the Utilization of Teleneurology and Other Healthcare Resources Prior to and During the COVID-19 Pandemic in an Urban, Tertiary Health System

“…In the first and second quarters of 2020, the global public health emergency caused by the novel coronavirus (coronavirus disease 2019 or COVID-19) promoted widespread adoption of telemedicine and teleneurology (TN) as patients and providers sought to minimize virus transmission and preserve access to neurological care worldwide (1)(2)(3)(4)(5)(6). Building on the limited uptake of both telemedicine and TN preceding the COVID-19 pandemic, (7,8) the COVID-19 crisis saw rapid increases in acceptance among neurologists for TN, which firmly established the latter as a viable care model in neurological populations (9). Despite the widespread adoption of TN and non-neurological telemedicine during the COVID-19 pandemic, several authors have noted sociodemographic differences in access to telemedicine during this period, raising the possibility of inequitable care (10)(11)(12)(13)(14) and potentiation of existing health disparities.…”