The Latest in Telehealth Offerings: Teleneurology
By Devin Partida, Editor-in-Chief, ReHack.com
Twitter: @rehackmagazine
There’s been a recent boom in telehealth services that some people say could forever change care delivery. Teleneurology is a related trend. Here’s a look at what it is and how the option could help patients.
What Is Teleneurology?
Teleneurology allows neurologists to see patients remotely in emergency and nonurgent situations. For example, the option can help stroke patients get faster care if the hospital they arrive at does not have an available neurologist on site. However, teleneurology can also provide better access to care for people who have ongoing visits with their neurologists and cannot easily travel to see them in person. Teleneurology appointments can allow patients to describe their symptoms or get medication adjustments without actual visits.
Teleneurology Enables Better Treatment Decisions
Deciding whether to treat a patient in a certain way requires examining numerous factors before proceeding. Some medications benefit people and harm others depending on the specifics of their illness.
Casey Stell is an emergency room physician at Texas Health Cleburne, which uses teleneurology services whenever a patient presents with stroke-like symptoms. Video screens connect emergency room doctors with a neurologist located at another hospital in the state. The patient immediately gets a CT scan to determine if they have an acute case involving bleeding. If not, a medication called Alteplase might be an appropriate treatment for clots that caused a stroke. However, the remotely located neurologist plays a key role in making that call.
Stell explains, “We have to give that [medicine] within a certain amount of hours. The nurses will get the neurologist on [the telemedicine platform], and the neurologist will see the patient and determine if they are indeed a candidate for Alteplase. As wonderful as it is, it is also a dangerous medicine because it can cause bleeding throughout the body. So if there wasn’t a bleed before, it could cause that, and we don’t like to give it willy-nilly.”
Physician availability and response time are two crucial quality metrics that show whether a teleneurology program brings the desired outcomes. When an emergency room team can speak to a neurologist quickly, the patient is more likely to have a good recovery. One telehealth platform on the market takes only 45 seconds to connect physicians to vascular neurologists. It also does not require users to go through a call center first.
Teleneurology Keeps Vulnerable Patients Safer
Telemedicine has proved its worth during the COVID-19 pandemic. However, it’s likely to remain useful even after the health threat eases. Remotely delivered care lets at-risk patients stay safe in their homes without interrupting medical access.
A study examined the effects of teleneurology during COVID-19 for patients needing outpatient neurology care. Researchers chose a three-week span and found a 533% increase in remote visits for that group. The neurologists used widely available video chat tools or phone calls to connect with patients.
Most visits during the period were between patients and providers with whom an established relationship existed. However, in more than 700 instances, the visits occurred between neurologists and first-time patients. The providers addressed conditions including epilepsy, movement disorders, headaches and multiple sclerosis.
The research occurred when stay-at-home orders applied to much of the United States. However, teleneurology could promote patient safety at other times, too. For example, severely immunocompromised neurology patients may regularly avoid leaving their homes during cold and flu outbreaks in their areas, knowing that getting ill could have catastrophic consequences.
Teleneurology Supplements the Expertise at Smaller Hospitals
Teleneurology is also tremendously advantageous for smaller facilities or those in rural areas that may not have neurologists available at all times. In such cases, a remote practitioner could provide advice when a facility’s workload is unmanageable for the on-site staff.
Massachusetts General Hospital partners with 34 community hospitals to provide telestroke and teleneurology assistance in such cases. The associated data showed that more than 95% of such consultation requests were responded to within five minutes. Patient satisfaction rates reached above 90%, too. Clinicians also reported that they felt more confident making decisions about emergency and routine cases due to the teleneurology options available to them.
This example shows that it could make good business sense to expand the model elsewhere. Many health care providers regularly use technology, which should reduce associated learning curves.
Expect More Instances of Teleneurology Use
Even the most skilled physicians often need advice from other medical professionals. Teleneurology platforms help them get it. Plus, remote care removes barriers related to traveling to a facility, finding care for a patient’s young kids or dealing with the potential downsides of taking time off work to go to physical appointments. For these reasons and others, health care professionals should anticipate wider teleneurology adoption rates moving forward.
