Future Neurohospitalist

Abstract

Despite the growing demand for emergency neurological evaluations and neurohospitalists, the supply of neurologists remains relatively fixed over time. Telemedicine is a unique tool that has the ability to put a medical specialist like a neurologist in 2 places in a relatively short period of time, expanding expertise in many rural and in some underserved urban facilities that would ordinarily be devoid of such expertise. Teleneurology is a branch of telemedicine that consults and practices through remote neurological evaluation. Telestroke is defined as remote stroke evaluation. The demand for timely neurological evaluation, especially acute stroke evaluation and treatment with intravenous recombinant tissue plasminogen activator (IV rtPA), continues to fuel the growth of neurohospitalists, telestroke, and teleneurology services. Remote, rural, or underserved urban emergency departments and hospitals which are unable to successfully recruit a neurologist or neurohospitalist to provide this service are uniquely suited to a teleneurology option. The number of private practices and academic centers providing telestroke services has grown significantly in the past decade with continued growth expected. We describe the benefits and drawbacks of teleneurology/telestroke, as well as other practical aspects for the teleneurohospitalist.

Telemedicine Quality and Outcomes in Stroke: A Scientific Statement for Healthcare Professionals From the American Heart Association/American Stroke Association

“…This is particularly important, given that telestroke networks are often used for nonstroke cases, including stroke mimics and nonstroke neurology requests by telemedicine sites. 101 Rates of stroke mimics among those presenting acutely for the sudden onset neurological deficits are as high as 30% [102][103][104] with similar rates in telestroke settings (11% 37 -22% 105 ). Given the time pressures of decision making in ischemic stroke and the similarity of presentation for ischemic stroke and many stroke mimics, treatment rates of stroke mimics are 6% to 16%.…”

Retinal microvascular network alterations: potential biomarkers of cerebrovascular and neural diseases

“…Moreover, the opportunity of telemedical consultation offered by current mobile retinal imaging devices has now improved the access not only to accurate, but timely subspecialty care, especially for underserved regions (68). This may open a new avenue for increasing retinal imaging applications in neurologic and psychiatric teleconsultations as it is currently in place for retinal diseases (32,68).…”

Utilization of a Mobile Videoconferencing Tool (FaceTime) for Real-time Evaluation of Critically Ill Neurosurgical Patients

“…1 Recently, in our neurointensive care unit (NICU), there have been several patients who would benefit from a visual assessment of their presentation or monitoring information. 1 Recently, in our neurointensive care unit (NICU), there have been several patients who would benefit from a visual assessment of their presentation or monitoring information.…”