Expanding The Use of Telemedicine in Neurology: A Pilot Study

Abstract

Background: Telemedicine enables providers to connect with patients and consultants remotely in a cost-effective, convenient manner. Telemedicine in various forms-from store-and-forward technology to real-time videoconferencing-has demonstrated good outcomes in specialties including neurosurgery, general neurology, stroke, and epilepsy. Aim: To demonstrate the feasibility of telemedicine in an outpatient university-based neurology clinic, and assess patient and provider satisfaction with telemedicine. Methods: Forty neurologically stable adult patients were recruited. We excluded patients who were non-English speaking, had intellectual disability, lacked caregiver availability, or had unstable neurological conditions. After each telemedicine visit a patient standardized satisfaction survey was completed, comprising 11 questions assessing patient willingness to participate, technical issues, and satisfaction with the clinic experience and medical provider. A provider satisfaction survey was obtained at the end of the study. Results: Forty of fifty patients meeting criteria consented to a telemedicine visit in lieu of a routine visit, and 15 of these responded to survey. All felt confident when meeting with their provider met their needs. Ninety percent of participants agreed that the technical process of joining the on-line session was easy. All patients agreed that they were satisfied with their telemedicine session and would choose telemedicine over face-to-face visits in the future. Cost analysis demonstrated a UCLA healthcare system saving of $28.00 for each telemedicine replacing an in-person clinic visit. Patients saved the cost of auto fuel, missed work, and parking when using the telemedicine option. Conclusions: Telemedicine in neurology patients is feasible and satisfies patients and providers.

The application of telehealth to remote and rural Australians with chronic neurological conditions

“…This study aimed to explore the patient satisfaction of telehealth in Australia to address the challenges of rural and remote patients. To this end, this study corroborates with other studies that have demonstrated the feasibility and benefits of telehealth [2][3][4][5][6][7][8][9] and upholds that rural Australia also mirrors such enthusiasm. We saw 13 patients across 29 encounters in 1 year by telehealth.…”

“…5 With the application of telehealth, these remote and underserved populations benefit from reduced geographical disparity, driving time, fuel usage, and parking and travel costs. 6,7 A prospective and retrospective study showed that traditional consultations led to missed work due to travel, while telehealth was, in contrast, a cost-effective and convenient alternative. 8 The benefits of telehealth have been demonstrated through substantial research and indicate a need to support its expansion.…”

“…The increased implementation of telehealth addresses the inequitable access to health services and by extension the poorer health status in rural Australia 5 . With the application of telehealth, these remote and underserved populations benefit from reduced geographical disparity, driving time, fuel usage, and parking and travel costs 6,7 . A prospective and retrospective study showed that traditional consultations led to missed work due to travel, while telehealth was, in contrast, a cost‐effective and convenient alternative 8 .…”

Accelerated launch of video visits in ambulatory neurology during COVID-19

“…3,4 However, challenges including technical and connectivity issues, 5 limitations with the physical examination, [6][7][8][9][10][11] and lack of personal interaction are nontrivial issues that must be addressed to enable broad implementation of neurologic video visits. 10 These and other challenges 1,9,[11][12][13][14][15][16] have resulted in variable and incremental uptake within the ambulatory neurology setting. With the onset of the SARS-CoV-2 (COVID-19) pandemic, the applicability of and necessity for video visits changed and was rapidly put to the test across all subspecialties in neurology.…”

Rapid Implementation of Video Visits in Neurology During COVID-19: Mixed Methods Evaluation (Preprint)

“…Nonetheless, integration of virtual visits into ambulatory neurology care, where the physical examination and nuanced communication play a strong role, has been received with some hesitation [7,[9][10][11][12][13]. Further, issues related to technology, compensation, payor reimbursement, policy, hardware/software costs, credentialing, liability, and requirements for in-person evaluations prior to virtual care, have also limited its adoption [1,8,11,[13][14][15][16][17].…”