For people with many neurologic disorders, seeing the neurologist by video may be as effective as an in-person visit, according to a review of the evidence conducted by the American Academy of Neurology (AAN). The evidence review examined all available studies on use of telemedicine for several neurologic conditions – stroke being one of the conditions that is well-validated and highly utilizes telemedicine – and is published in the December 4, 2019, online issue of Neurology®, the medical journal of the AAN. The results indicate that a diagnosis from a neurologist by video for certain neurologic conditions is likely to be as accurate as an in-person visit.
Telemedicine is the use of video conferencing or other technology for doctor visits from another location. The patient could be at home or at a local doctor's office.
Telemedicine can be especially helpful for people with epilepsy, who may not be able to drive to appointments, people with neurologic disorders like multiple sclerosis and movement disorders, who may have mobility issues that make getting to a clinic difficult, and, of course, for people in rural areas who may not be able to see a neurologist based hours away without making that trip. Another effective use may be for evaluating people with possible concussions, where telemedicine could be used on-site to make an immediate diagnosis. For sports injuries, it could be used to make a decision on whether the athlete is ready to return to the field."
Jaime Hatcher-Martin, MD, PhD, lead author who was with Emory University in Atlanta while serving on the American Academy of Neurology's Telemedicine Work Group, is now with the company SOC Telemed and is a member of the American Academy of Neurology
For the evidence review, the researchers analyzed 101 studies on telemedicine use in the areas of concussion and traumatic brain injury, dementia, epilepsy, headache, multiple sclerosis, movement disorders, neuromuscular conditions and general neurology. Hatcher-Martin noted that evidence for the use of telemedicine for stroke has been well-established.
Overall, studies found that patients and their caregivers were just as satisfied with virtual doctor visits as they were with in-person visits. Some studies show that using telemedicine is as effective as in-person visits to make accurate diagnoses and in some cases may show improved health outcomes. However, few randomized, controlled studies have been conducted on telemedicine for neurology, outside of stroke. In many areas, little research has been done.
"This is just the beginning of evaluating the benefits of telemedicine in neurology," said senior author Raghav Govindarajan, MD, of the University of Missouri, who served as a chair on the American Academy of Neurology's Telemedicine Work Group and is a Fellow of the American Academy of Neurology.
"We need to conduct further studies to better understand when virtual appointments are a good option for a patient. Keep in mind that telemedicine may not eliminate the need for people to meet with a neurologist in person. Rather, it is another tool that can help increase people's access to care and also help lessen the burden of travel and costs for patients, providers and caregivers."