The VA National TeleNeurology Program (NTNP) began a general neurology service in 2020 to provide care focused on rural Veterans across the country. While the value of accessible general neurologists has been demonstrated, providing additional, high-quality care through the implementation of a MDT is feasible and can further optimize care.

We developed and deployed a MDT within NTNP and monitored the utilization of these services over the course of the first year all services were available. The MDT included social workers, a clinical pharmacist, neuropsychologists, a speech-language pathologist (SLP), registered nurses, an advanced practice provider (APP) and 11 different neurology subspecialists, using either video telehealth (TH) or e-consults (EC) to deliver care.

During a rolling, 12-months (Fiscal Year 24[Q4]; FY25 [Q1-3], NTNP successfully implemented the program and monitored the numerous encounters of MDT providers totaling 1,459 TH visits and 872 EC, in addition to 9,799 general neurology TH visits. Specifically, the following encounters were completed: social work (50 TH; 86 EC), pharmacy (33 TH; 158 EC), neuropsychology (146 TH), SLP (102 TH), nursing education clinic (693 TH), nursing blood-pressure clinic (237 TH), APP clinic (198 TH), and 628 neurology subspecialty EC.

Incorporating a MDT into a national teleneurology program is feasible and increases access to neurology-based services for patients with disabling, chronic disease, often facing challenges to access care, particularly those in rural or underserved areas. The deployment of this MDT model in a virtual setting facilitates personalized health innovations and increases collaboration as well as shared decision making among patients, caregivers and the variety of provider-types essential to patient-centered care. We have demonstrated use of these services via the NTNP MDT, providing a novel care model which could be beneficial to other virtual clinical teams going forward.