Rachel Dum1, Katrina Bakhl1, James Grogan2
1Penn State College of Medicine, 2Pennsylvania State University Hershey Medical Center
Objective:
This systematic review of patient and provider preferences identifies best practices for using telehealth as a clinical model.
Background:
Since the COVID-19 pandemic, tele-neurology has remained a new standard and tool for access to neurologic care. One projection predicts that by 2025, the need for neurologists will exceed availability by 19%. As neurologic disorders are the leading cause of global disability, virtual care offers a powerful tool for maintaining specialty care access. Current literature reveals inconsistencies in both patient and provider perceptions of quality between virtual and in-person consultations.
Design/Methods:
To review patient and provider satisfaction within outpatient tele-neurology, PubMed, Scopus, Web of Science, and the Cumulated Index to Nursing and Allied Health Literature (CINAHL) databases were searched with key phrase: (tele-neurology OR tele-neurology OR neurology e-consult OR ((telehealth or telemedicine) AND neurology)) AND (patient satisfaction OR physician satisfaction). This yielded 535 results. Of these, 143 article duplicates were removed, 118 articles were removed in article title screening, 60 articles were removed in abstract review, and 42 articles were removed in main body review, leaving 172 total articles used. Exclusion criteria were pediatric or adolescent patient populations and inpatient tele-neurology services.
Results:
An overwhelming majority of studies reported high patient and provider satisfaction with tele-neurology, with high feasibility, safety, efficacy, and acceptability ratings despite common challenges of technical issues, physical exam limitations, and communication. While many studies reported virtual visits to expand access for rural patients, tele-neurology may exacerbate access disparities for minority, older, male, and Medicare/Medicaid-using patients. Recommendations for virtual communication, trainee utilization, and conducting remote physical exams exist in the literature, although techniques remain unvalidated.
Conclusions:
Tele-neurology can be non-inferior in diagnostic accuracy and patient/provider satisfaction compared to traditional in-person outpatient consultations. If rural patients have adequate internet access, tele-neurology may increase access.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.