Teleneurological services increased significantly during the COVID-19 pandemic and patients generally reported positive experiences with these services. Providers initially reported a less favorable experience, but this later improved during implementation, according to study results published in Neurology Clinical Practice.
The aim of the current study was to determine the results of the expansion of teleneurology in response to the COVID-19 pandemic in a tertiary healthcare system in New York City, including synchronous (video visit) and asynchronous (store-and-forward, patient) Portal evaluation, remote monitoring) teleneurology services.
Using data from the Neurology Department of Mount Sinai Health Systems in New York, collected two months before and after the department’s response to the COVID-19 pandemic, the study researchers assessed teleneurology usage. Post-visit surveys with clinicians and patients were used to assess the experience and acceptance of the platforms used.
The study researchers identified a total of 117 teleneurology clinicians (in 14 specialties) who performed 4225 unique teleneurology visits (52 before COVID-19 and 4173 during COVID-19) with 3717 patients. They did not identify any asynchronous teleneurology services during the study period.
From the first to the second period, the total number of clinicians performing teleneurological visits increased by 963%, the number of subspecialties providing teleneurological services increased by 133%, and the total number of teleneurological visits increased by 7925%. Most of the video visits were made with Epic MyChart (78.5%) and Zoom (8.1%).
The patients generally reported a high level of acceptance of synchronous teleneurology. The mean overall acceptance score (with 1 being the lowest to 5 being the highest) was 4.7. The lowest individual experience rating was 4.4 for easy registration for the teleneurology visit, followed by 4.5 for the clarity of the instructions for registering during the visit.
Clinicians’ numerical rating of the likelihood of recommending teleneurologists to peers was 3.4 on a scale of 1 to 5 (1 very unlikely to 5 very likely), although the ratings improved to 4.1 as the experience was rated by clinicians at the end of the study.
The study had several limitations, including the lack of data on the reasons why patients or providers chose teleneurology instead of phone calls or postponing care, the exclusion of phone calls from the definition of teleneurology, the use of anonymous survey data for patients and others Clinician’s experience with potential response bias and a lack of long-term data on the effects of teleneurology.
“A significant expansion of [teleneurology (TN)] Use accompanied the [COVID-19] Answer. The patients found TN more acceptable than the doctors. The proactive use of an implementation framework enabled rapid and effective TN expansion, ”concluded the study’s researchers.
Disclosure: One study author declared his affiliation with the pharmaceutical industry. For a full list of the authors’ information, see the original reference.
Kummer B, Sweetnam C, Vickrey BG et al. Expanding teleneurology in response to the COVID-19 outbreak in a tertiary health system in New York City. Neurol Clin Pract. Published online March 9, 2021. doi: 10.1212 / CPJ.0000000000001057