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Seigel CR, Martin H, Bastin G, Myers LJ, Taylor S, Pike F, Wilkinson J, Williams LS. Patient acceptance of teleneurology across neurologic conditions. J Neurol 2024; 271:2850-2858. [PMID: 38388928 PMCID: PMC11055742 DOI: 10.1007/s00415-024-12200-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/08/2024] [Accepted: 01/16/2024] [Indexed: 02/24/2024]
Abstract
INTRODUCTION Patient acceptability with outpatient teleneurology has been reported within specific conditions, but less is known about acceptability across neurologic conditions. The study objective was to compare the acceptability of teleneurology between patients with various neurological conditions and determine what other factors influence acceptability. METHODS This was a prospective study of Veterans who completed new outpatient teleneurology visits with the Department of Veterans Affairs National Teleneurology Program. Visits were conducted via video to home or video to the outpatient clinic. Patient acceptability was assessed via telephone interview two weeks post-visit. Acceptability was a summed score (3-21) of three 7-point Likert questions (higher = more acceptable). Clinical diagnosis categories were based on the neurologists' ICD10 diagnosis code. Acceptability score was modeled using a censored Tobit model controlling for demographics, type of tele-visit, medical comorbidity, and ICD10 category. RESULTS In FY 2021, 277 of 637 (43.5%) patients completed an interview with analyzable acceptability data. Of these 277, 70 (25.3%) had codes indicating headache, 46 (16.6%) movement disorder, 45 (16.2%) general symptoms, and 116 (41.9%) for all other categories. Mean patient acceptability was 18.3 (SD 3.2). There was no significant difference in scores between these groups. The only factor independently related to acceptability was medical comorbidity, with higher comorbidity associated with higher acceptability scores. DISCUSSION Patients find their outpatient teleneurology experience highly acceptable independent of neurologic condition. Those with more comorbidity report higher acceptability. Use of teleneurology may be useful and acceptable across many outpatient neurologic conditions including for more medically complex patients.
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Affiliation(s)
| | - Holly Martin
- Richard L. Roudebush VAMC HSR&D EXTEND QUERI, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Grace Bastin
- Richard L. Roudebush VAMC HSR&D EXTEND QUERI, Indianapolis, IN, USA
| | - Laura J Myers
- Indiana University School of Medicine, Indianapolis, IN, USA
- Richard L. Roudebush VAMC HSR&D EXTEND QUERI, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
| | - Stan Taylor
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Francis Pike
- Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Jayne Wilkinson
- Corporal Michael J Crescenz VAMC, Philadelphia, PA, USA
- Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda S Williams
- Richard L. Roudebush VAMC HSR&D EXTEND QUERI, Indianapolis, IN, USA
- Regenstrief Institute, Inc., Indianapolis, IN, USA
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
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Thawani SP, Minen MT, Grossman SN, Friedman S, Bhatt JM, Foo FYA, Torres DM, Weinberg HJ, Kim NH, Levitan V, Cardiel MI, Zakin E, Conway JM, Kurzweil AM, Hasanaj L, Stainman RS, Seixas A, Galetta SL, Balcer LJ, Busis NA. A Comparison of Patients' and Neurologists' Assessments of their Teleneurology Encounter: A Cross-Sectional Analysis. Telemed J E Health 2024; 30:841-849. [PMID: 37624656 DOI: 10.1089/tmj.2023.0168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023] Open
Abstract
Background and Objectives: To better understand patients' and neurologists' assessments of their experiences regarding effectiveness of teleneurology encounters. Methods: Following an audio-video telehealth visit, neurologists asked patients to participate in a survey-based research study about the encounter, and then, the neurologists also recorded their own evaluations. Data were analyzed using standard quantitative and qualitative techniques for dichotomous and ordered-category survey responses in this cross-sectional analysis. Results: The study included unique encounters between 187 patients and 11 general neurologists. The mean patient age was 49 ± 17.5 years. Two thirds of the patients (66.8%, 125/187) were female. One third (33.2%; 62) were patients new to the NYU Langone Health neurology practices. The most common patient chief complaints were headache (69/187, 36.9%), focal and generalized numbness or tingling (21, 11.2%), memory difficulty (15, 8%), spine-related symptoms (12, 6.4%), and vertigo (11, 5.9%). Most patients (94.7%, 177/187) reported that the teleneurology encounter satisfied their needs. Patients and their neurologists agreed that the experience was effective in 91% (162/178) of encounters, regardless of whether the visit was for a new or established patient visit. Discussion: More than 90% of new and established patients and their neurologists agreed that teleneurology encounters were effective despite some limitations of the examination, the occasional need for patient assistance, and technical difficulties. Our results provide further evidence to justify and to expand the clinical use of teleneurology.
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Affiliation(s)
- Sujata P Thawani
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Mia T Minen
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Scott N Grossman
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Steven Friedman
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
| | - Jaydeep M Bhatt
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Farng-Yang A Foo
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Daniel M Torres
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Harold J Weinberg
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Nina H Kim
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Valeriya Levitan
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Myrna I Cardiel
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Elina Zakin
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Jenna M Conway
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Arielle M Kurzweil
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Lisena Hasanaj
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Rebecca S Stainman
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
| | - Azizi Seixas
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Informatics and Health Data Science, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Steven L Galetta
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA
| | - Laura J Balcer
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
- Department of Population Health, NYU Grossman School of Medicine, New York, New York, USA
- Department of Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA
| | - Neil A Busis
- Department of Neurology, NYU Grossman School of Medicine, New York, New York, USA
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Thawani SP, Minen MT, Stainman RS, Friedman S, Bhatt JM, Foo FYA, Torres DM, Weinberg HJ, Kim NH, Levitan V, Cardiel MI, Zakin E, Conway JM, Kurzweil AM, Hasanaj L, Galetta SL, Balcer LJ, Busis NA. Neurologists' Evaluations of Experience and Effectiveness of Teleneurology Encounters. Telemed J E Health 2023; 29:442-453. [PMID: 35834603 DOI: 10.1089/tmj.2021.0551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background and Objectives: To better understand neurologists' assessments of the experiences and effectiveness of teleneurology encounters. Methods: After completing an audio-video telehealth visit with verbally consenting patients, neurologists recorded their evaluations of the encounter. Data were analyzed using standard quantitative and qualitative techniques. Results: The study included unique encounters between 187 patients and 11 neurologists. The mean patient age was 49 ± 17.5 years. Two thirds of patients (66.8%, 125/187) were female. One third of patients (33.2%; 62) were new patients. The most common patient complaints were headache (69/187, 36.9%), focal and generalized numbness or tingling (21, 11.2%), memory difficulty (15, 8%), spine-related symptoms (12, 6.4%), and vertigo (11, 5.9%). Neurologists reported that they completed a virtual examination that provided enough information for medical decision-making in 94.9% of encounters (169/178, 9 missing responses). Fourteen of 25 examination elements important for medical decision-making could be performed sufficiently during virtual encounters. Examination assistance was needed for 16.4% (30/183) of patients, who were, on average, 17.3 years older than those who did not require assistance (62.9 years vs. 45.6 years, p = 0.0002). In 19.1% (34/178) of encounters, neurologists learned clinically relevant information from seeing patients in their homes. Neurologists' assessments of the effectiveness of encounters were not related to the presence (97.2%, 35/36 effective) or absence (95%, 134/141 effective) of technical difficulties (p = 0.5729) in 177 encounters (10 missing responses). Discussion: Neurologists reported that nearly 95% of teleneurology encounters were effective despite limitations of the virtual examination, occasional need for patient assistance, and technical difficulties.
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Affiliation(s)
- Sujata P Thawani
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Mia T Minen
- Department of Neurology and NYU Langone Health, New York, New York, USA.,Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Rebecca S Stainman
- Department of Neurology, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Steven Friedman
- Department of Population Health, NYU Langone Health, New York, New York, USA
| | - Jaydeep M Bhatt
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Farng-Yang A Foo
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Daniel M Torres
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Harold J Weinberg
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Nina H Kim
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Valeriya Levitan
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Myrna I Cardiel
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Elina Zakin
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Jenna M Conway
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | | | - Lisena Hasanaj
- Department of Neurology and NYU Langone Health, New York, New York, USA
| | - Steven L Galetta
- Department of Neurology and NYU Langone Health, New York, New York, USA.,Department of Ophthalmology, NYU Langone Health, New York, New York, USA
| | - Laura J Balcer
- Department of Neurology and NYU Langone Health, New York, New York, USA.,Department of Population Health, NYU Langone Health, New York, New York, USA.,Department of Ophthalmology, NYU Langone Health, New York, New York, USA
| | - Neil A Busis
- Department of Neurology and NYU Langone Health, New York, New York, USA
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Lau KHV, Anand P, Ramirez A, Phicil S. Disparities in Telehealth use During the COVID-19 Pandemic. J Immigr Minor Health 2022; 24:1590-1593. [PMID: 35976473 PMCID: PMC9382002 DOI: 10.1007/s10903-022-01381-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 12/01/2022]
Abstract
The coronavirus 2019 pandemic led to rapid expansion of outpatient telemedicine. We sought to characterize patient factors influencing outpatient teleneurology utilization at an urban safety-net hospital. We reviewed all neurology televisits scheduled between June 15, 2020 to April 15, 2021. We used the chi-squared test and multivariate logistic regression to characterize patient demographic factors associated with televisit completion and video use. Of 8875 scheduled televisit encounters, 7530 were completed successfully, 44% via video. Non-English speaking patients, Black patients, Latinx patients, and those with a zip code-linked annual income less than $50,000 were less likely to successfully complete a scheduled televisit. The same demographic groups other than Latinx ethnicity were also less likely to use the video option. Our study found unequal telehealth utilization based on patients’ demographic factors. Currently declining telemedicine reimbursement rates asymmetrically affect audio-only visits, which may limit telehealth access for vulnerable patient populations.
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Affiliation(s)
- K H Vincent Lau
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA. .,Department of Neurology, Boston Medical Center, Boston, MA, USA.
| | - Pria Anand
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston Medical Center, Boston, MA, USA
| | - Alex Ramirez
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston Medical Center, Boston, MA, USA
| | - Sheila Phicil
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA.,Department of Neurology, Boston Medical Center, Boston, MA, USA
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Agusti A, Pallisa E, Escudero D, Escobar M. Propuestas JANUS para la mejora de la experiencia de la persona atendida en consultas externas. Med Clin (Barc) 2022; 159:549-553. [DOI: 10.1016/j.medcli.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 10/16/2022]
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6
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Meng G, McAiney C, Perlman CM, McKillop I, Tisseverasinghe T, Chen HH. Service process factors affecting patients' and clinicians' experiences on rapid teleconsultation implementation in out-patient neurology services during COVID-19 pandemic: a scoping review. BMC Health Serv Res 2022; 22:534. [PMID: 35459134 PMCID: PMC9026006 DOI: 10.1186/s12913-022-07908-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background The adoption of teleconsultation for outpatient neurology services was limited until the onset of the COVID-19 pandemic which forced many outpatient neurology services to rapidly switch to virtual models. However, it remains unclear how this change has impacted patients’ and clinicians’ perceptions of service quality. The purpose of this scoping review is to identify process factors that influence patients’ and clinicians’ experiences of outpatient teleconsultation services during COVID-19. Methods Arksey and O’Malley scoping review framework was used to search PubMed, Scopus, CINAHL, and PsycInfo for original peer-reviewed research studies that examined the experiences of synchronous teleconsultation between a clinician and patient in a home-setting since the World Health Organization announced the COVID-19 global pandemic. The service quality model SERVQUAL was used to conduct a deductive thematic analysis to identify the key factors that impacted the patients’ and clinicians’ perception of teleconsultation services. Results A total of nineteen studies published between January 1, 2020, and April 17, 2021, were identified. The most common service process factors affecting the patients’ and clinicians’ experiences of teleconsultation were technical issues, addressing logistical needs, communication, ability to perform clinical activities, appropriate triage, and administrative support. Conclusions Our findings identified six key service process factors affecting the patients’ and clinicians’ teleconsultation experiences in outpatient neurology services. The need for improvement of triage process and standardizing administrative virtual care pathway are identified as important steps to improve patients and clinicians’ teleconsultation experiences compared to pre-COVID era. More research is needed to assess outpatient neurology teleconsultation service quality from patients’ and clinicians’ perspectives. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07908-4.
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Affiliation(s)
- Guangxia Meng
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada.
| | - Carrie McAiney
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Christopher M Perlman
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | - Ian McKillop
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
| | | | - Helen H Chen
- School of Public Health Sciences, University of Waterloo, 200 University Ave W, Waterloo, ON, N2L 3G1, Canada
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7
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Asukile M, Chishimba L, Chomba M, Mataa M, Mutete F, Mwendaweli N, Yumbe K, Zimba S, Habanyama G, Shampile S, Makupe A, Saylor D. Implementation of a Teleneurology Clinic in Zambia during the COVID-19 Pandemic. Ann Neurol 2022; 91:445-454. [PMID: 35150000 PMCID: PMC9082463 DOI: 10.1002/ana.26323] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of this study was to assess the feasibility, acceptability, and benefits of a teleneurology clinic serving adults usually attending a neurology outpatient clinic in Lusaka, Zambia during the coronavirus disease 2019 (COVID-19) pandemic. METHODS Televisits were offered to patients scheduled for neurology appointments between March and July 2020 using the telephone, WhatsApp video, or Zoom calls based on patient accessibility. Visit outcomes were documented, and patient and neurologist satisfaction surveys were completed. RESULTS Of 323 patients, 195 (60%) were reachable by telephone, 179 of these were alive, and 74% (133/179) of those alive agreed to a televisit. Stroke (30%), seizures (20%), and headache (16%) were the most common diagnoses seen via televisit. Most televisits (80%) were by telephone call, 14% by WhatsApp video call, and 6% by Zoom. Nearly one-third (30%) of the patients were stable and discharged from the clinic, 32% only required medication refills, and 19% required an in-person visit. Sixty patients (out of 85 reachable and 71% response rate) and 7 of 9 neurologists (78% response rate) completed satisfaction surveys. Neurologists reported greater assessment confidence with Zoom, but confidence was high for all modalities. Patients preferring televisits (75%, 45/60) noted reduced expense and time requirements, whereas those preferring in-person visits (22%, 13/60) cited the desire for physical examinations. Overall, 98% of patients and 100% of neurologists were satisfied with televisits. INTERPRETATION Teleneurology visits were acceptable and feasible for adults attending an outpatient neurology clinic in Zambia and their neurologists. They offer a promising supplement to in-person visits in resource-limited settings, even when video-conference capabilities and electronic medical records are absent. ANN NEUROL 2022;91:445-454.
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Affiliation(s)
- Melody Asukile
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Lorraine Chishimba
- Department of Internal MedicineUniversity of Zambia School of MedicineLusakaZambia
| | - Mashina Chomba
- Department of Internal MedicineUniversity of Zambia School of MedicineLusakaZambia
| | - Moses Mataa
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Frighton Mutete
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Naluca Mwendaweli
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
- Department of Internal MedicineUniversity of Zambia School of MedicineLusakaZambia
| | - Kunda Yumbe
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Stanley Zimba
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | - Gloria Habanyama
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
| | | | | | - Deanna Saylor
- Department of Internal MedicineUniversity Teaching HospitalLusakaZambia
- Department of NeurologyJohns Hopkins University School of MedicineBaltimoreMD
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Jones LK, McClean JC, Avitzur O. US Health Care System in 2035: The Neurology Future Forecasting Series. Neurology 2022; 98:402-408. [PMID: 35256518 DOI: 10.1212/wnl.0000000000200057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 07/28/2021] [Indexed: 11/15/2022] Open
Abstract
Evolution of the US health care system has been punctuated by periods of rapid change. In the coming decades there will be meaningful and potentially disruptive developments in health care delivery mechanisms, the policy environment, and the populations for whom we provide care. Neurologists will need to adapt to changing patient expectations, market dynamics, and regulatory structures to thrive in the future health care environment. This article describes a forecast of potential changes in the US health care system by 2035, an assessment of the implications for the field of neurology, and a rationale for long-term strategic planning to prepare.
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Affiliation(s)
- Lyell K Jones
- From the Mayo Clinic (L.K.J.), Rochester, MN; San Antonio Military Medical Center (J.C.M.), TX; and American Academy of Neurology (O.A.), Tarrytown, NY.
| | - Jeffrey C McClean
- From the Mayo Clinic (L.K.J.), Rochester, MN; San Antonio Military Medical Center (J.C.M.), TX; and American Academy of Neurology (O.A.), Tarrytown, NY
| | - Orly Avitzur
- From the Mayo Clinic (L.K.J.), Rochester, MN; San Antonio Military Medical Center (J.C.M.), TX; and American Academy of Neurology (O.A.), Tarrytown, NY
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9
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Hatcher-Martin JM, Busis NA, Cohen BH, Wolf RA, Jones EC, Anderson ER, Fritz JV, Shook SJ, Bove RM. American Academy of Neurology Telehealth Position Statement. Neurology 2021; 97:334-339. [PMID: 33986141 PMCID: PMC8377877 DOI: 10.1212/wnl.0000000000012185] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 04/19/2021] [Indexed: 12/18/2022] Open
Abstract
Telehealth services complement in-person neurologic care. The American Academy of Neurology 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.
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Affiliation(s)
- Jaime M Hatcher-Martin
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Neil A Busis
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Bruce H Cohen
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Rebecca A Wolf
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco.
| | - Elaine C Jones
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Eric R Anderson
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Joseph V Fritz
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Steven J Shook
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
| | - Riley M Bove
- From SOC Telemed (J.M.H.-M., E.C.J., E.R.A.), Reston, VA; NYU Langone Health (N.A.B.), New York, NY; Akron Children's Hospital (B.H.C.), OH; American Academy of Neurology (R.A.W.), Minneapolis, MN; Corticare (E.R.A.), Carlsbad, CA; Intensive Neuro (E.R.A.), St. Petersburg, FL; Dent Neurologic Institute (J.V.F.), Amherst, NY; Neurological Institute (S.J.S.), Cleveland Clinic, OH; and University of California (R.M.B.), San Francisco
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10
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Vazquez J, Islam T, Gursky J, Beller J, Correa DJ. Access to Care Matters: Remote Health Care Needs During COVID-19. Telemed J E Health 2020; 27:468-471. [PMID: 33017270 DOI: 10.1089/tmj.2020.0371] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic is straining health care worldwide with >31 million confirmed cases. Currently, 1 in every 100 U.S. residents and 245,000 in New York City are confirmed positive. The Bronx, with high-risk comorbidities, due in part to socioeconomic factors, has seen disproportionately higher rates of COVID-19-related complications. Poor health care access is exacerbated as in-person visits now pose viral transmission risk. There has been limited discourse regarding widespread disparities underlying transitions to telemedicine. Methods: We review perspectives in recent literature on telemedicine and its potential within neurology. Results: While telemedicine has reduced strain on in-person visits, preliminary reflections highlight implementation successes and challenges. Conclusions: To provide effective care beyond this crisis, fundamental changes in training, technological accessibility, and health care policy are needed. We propose open access to telehealth training, screening of patient's potential technological inequities and socioeconomic insecurities, and advocacy to secure broad long-term access to telehealth care.
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Affiliation(s)
- Juan Vazquez
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Jonathan Gursky
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.,Department of Neurology, Montefiore Medical Center, Bronx, New York, USA
| | - Jennifer Beller
- Department of Neurology, Montefiore Medical Center, Bronx, New York, USA
| | - Daniel Jose Correa
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA.,Department of Neurology, Montefiore Medical Center, Bronx, New York, USA
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