Telemedicine in neurology: where are we going?

Bramanti, Alessia; Calabrò, Rocco Salvatore

doi:10.1111/ene.13477

Cited by 14 publications

(7 citation statements)

References 5 publications

(7 reference statements)

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“…Telemedicine is a method of providing health care services, through the use of Information and Communication Technologies (ICT), in which the health professional and the patient (or two professionals) are far (3). In addition, telemedicine helps overcome patient's mobility problems and reduce NHS costs (4). There are various application areas of telemedicine, including telecardiology, teledermatology, telestroke, and telerehabilitation.…”

Section: Introductionmentioning

confidence: 99%

Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives

et al. 2020

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Section: Introductionmentioning

confidence: 99%

Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives

et al. 2020

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“…Tele-neurology is the use of real-time or delayed communication between neurologists and patients, or neurologists and other providers by way of shared audio, video, secure messaging, and other data exchanges which has been an important tool in improving the health and quality of life in those who are restricted to quality neurological care [1]. These restrictions to care are often due to geographic isolation; there are certain areas that lack a neurologist or patients must travel long distances to receive care [2-3]. There is a significant disparity between the need and availability of neurologists, especially in rural and underserved communities [4-5].…”

Section: Introductionmentioning

confidence: 99%

Multidisciplinary Approach and Outcomes of Tele-neurology: A Review

Patel¹,

Malik²,

DeMasi³

et al. 2019

Cureus

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In rural and underserved areas, there are restrictions in healthcare due to the lack of availability of neurologists; patients have to travel long distances to receive the required care. Considering the fact that neurological conditions have large mortality and disability rates, there is a need for innovative services like tele-neurology. It is an important tool in improving the health and quality of life by using different ways of communication between neurologists and patients, or neurologists and other providers. We examine the current types of facilities available in tele-neurology, as well as outcomes, barriers, limitations, legal litigations, and the multidisciplinary nature based on prior studies. We have also suggested recommendations for the future of tele-neurology including effective-accessibility and inexpensive-utilization in developing countries. There are various tele-health programs created by The Veterans Health Administration including a clinical video tele-health (CVT) system. This system allows direct patient care of veterans by neurologists. The University of South Carolina implemented a web-based tele-stroke program in which acute ischemic stroke patients were treated in the Emergency Department (ED) of rural hospitals by neurologists, after consulting with rural ED physicians. With growing technology and popularity of tele-neurology, there are now international collaborative efforts in tele-medicine that are looking to be adapted to tele-neurology. Thus, tele-neurology can provide quality neurological care with patient satisfaction, as well as time and cost savings. The tele-stroke group established by TRUST-tPA trial (Therapeutic Trial Evaluating Efficacy of Telemedicine (TELESTROKE) of Patients With Acute Stroke) has 10 community hospital-emergency rooms that were connected to a stroke center. It was found that tele-stroke is appropriate in places where there is no way for a patient to access a stroke unit within a 4.5-hour time window. Like other tele-neurology subtypes, tele-epilepsy and pediatric tele-neurology also offer more follow-up care to people of remote areas which have limited access. There are other subtypes like mental health, chronic neurological care, and hospitalist which are very effective in improving outcome and quality of life of people living in remote areas. Tele-neurology has effectively reduced travel costs and times; there is high patient satisfaction and reduced disparity for general and specialized neurological care. But there are certain limitations like large equipment costs, certain bandwidth requirement, and trained staff to use the equipment. Transmission of patient information using public internet raises the concern of legality. There should be sufficient encryption to satisfy the Health Insurance Portability and Accountability Act (HIPAA) requirements to ensure patient confidentiality and safety of personal data. The adaptation of tele-neurology is a powerful and innovative way to enhance healthcare in areas with a shortage o...

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“…In‐person visits decreased from the pre‐pandemic to pandemic period, whereas telehealth utilization increased. Patients and providers considered telehealth a viable solution to increase access to headache care, a trend seen for headache 12,13 and other neurological conditions 7,26,27 . Patients reported receiving high‐quality care via telehealth and remaining engaged in their headache‐related care without experiencing the stress and disruption of their routines that paradoxically may exacerbate the headache disorder for which they are seeking care 15,19,20,28 .…”

Section: Discussionmentioning

confidence: 99%

“…Patients and providers considered telehealth a viable solution to increase access to headache care, a trend seen for headache 12 , 13 and other neurological conditions. 7 , 26 , 27 Patients reported receiving high‐quality care via telehealth and remaining engaged in their headache‐related care without experiencing the stress and disruption of their routines that paradoxically may exacerbate the headache disorder for which they are seeking care. 15 , 19 , 20 , 28 Minimizing disruptions to the routine of patients with headache while maintaining high‐quality headache care is invaluable.…”

Section: Discussionmentioning

confidence: 99%

Telehealth perceptions and utilization for the delivery of headache care before and during the COVID‐19 pandemic: A mixed‐methods study

et al. 2022

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Objective:The objective of this study was to evaluate the utilization of telehealth for headache services within the Veterans Health Administration's facilities housing a Headache Centers of Excellence and multiple stakeholder's perspectives to inform future telehealth delivery.Background: Telehealth delivery of headache treatment may enhance patient access to headache care, yet little is known about the utilization or patient and provider perceptions of telehealth for veterans with headache. Methods: This mixed-methods study analyzed multiple data sources: (1) administrative data, which included 58,798 patients with medically diagnosed headache disorders, documented in at least one outpatient visit, from August 2019 through September 2020 from the 12 Veterans Health Administration's facilities with a Headache Center of Excellence and (2) qualitative semistructured interviews with 20 patients and 43 providers 6 months before the coronavirus disease 2019 (COVID-19) pandemic, and 10 patients and 20 providers 6 months during the beginning of the pandemic. Results: During the pandemic, in-person visits declined from 12,794 to 6099 (52.0%), whereas video (incidence rate ratio [IRR] = 2.05, 95% confidence interval [CI] = 1.66, 2.52), and telephone visits (IRR = 15.2, 95% CI = 10.7, 21.6) significantly increased.Utilization differed based on patient age, race/ethnicity, and rurality. Patients and providers perceived value in using telehealth, yet had limited experience with this modality pre-pandemic. Providers preferred in-person appointments for initial encounters and telehealth for follow-up visits. Providers and patients identified benefits and challenges of telehealth delivery, often relying on multiple delivery methods for telehealth to enhance patient engagement. Conclusions:The uptake of telehealth delivery of headache-related care rapidly expanded in response to the pandemic. Patients and providers were amenable to utilizing telehealth, yet also experienced technological barriers. To encourage equitable

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Telemedicine in neurology: where are we going?

Cited by 14 publications

References 5 publications

Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives

Tele-Neuro-Rehabilitation in Italy: State of the Art and Future Perspectives

Multidisciplinary Approach and Outcomes of Tele-neurology: A Review

Telehealth perceptions and utilization for the delivery of headache care before and during the COVID‐19 pandemic: A mixed‐methods study

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