Neil Holland1, Srijana Zarkou1, Trudi Dempsey2, Brandi McDonald2, Mary Frances Suter2, Catherine Caldwell2
1Neurology, 2Neurosciences Administration, Geisinger
Objective:
To demonstrate the impact of recruiting full-time remote tele-neurologists dedicated to new patient visits on access to local subspecialty neurology care.
Background:
Like other rural healthcare systems, Geisinger is experiencing challenges recruiting new local neurologists, and struggles to match an increasing demand for general neurology services with a limited pool of mostly sub-specialized providers. This contributes to longer wait times, delayed diagnoses, and unnecessary emergency room visits for our patients.
Design/Methods:
We onboarded 2 remote tele-neurologists dedicated to new patient visits at the end of 2024. Local providers also participate in new patient visits using any unplanned open clinic time. Patients are managed based on their diagnosis and needs - some are returned directly to their primary care providers with recommendations, others undergo further testing and limited follow-up, and those requiring ongoing or in-person care are referred on to the most appropriate local general or subspecialty providers. We tracked weekly volumes of new patient referrals, completed new patient visits, and number of new patient visits scheduled beyond 2-weeks.
Results:
We successfully recruited full-time remote neurologists into positions that had remained unfilled due to lack of local candidates. This increased our total out-patient neurology physician pool by 7% from 29 to 31 FTEs. We receive 250-300 new referrals each week and began 2025 with 2500 new patients scheduled beyond 2-weeks. By July 2025, our weekly completed new patient visits had increased by 35%, from 200 to 270, and new patients scheduled beyond 2-weeks had already decreased by 36% to 1600. Many patients living far from the clinic found an initial tele-video visit at home more convenient. Local providers reported seeing more patients appropriately triaged based on their diagnosis and urgency.
Conclusions:
Onboarding remote tele-neurologists has improved access and convenience for new patients, reduced our backlog of referrals, and optimized the availability and efficiency of local sub-specialists.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.