Virtual neurology visits match in-person care outcomes

For people who see a neurology clinician for the first time, a new study has found that being seen virtually vs. in-person made no difference in how soon they needed more care. The study was published April 22, 2026, in Neurology^®, the medical journal of the American Academy of Neurology.

While telemedicine has been shown to improve access to care for people in rural areas and for those without transportation, and telemedicine has received high satisfaction scores from both clinicians and patients, not a lot of research has been done on how effective virtual visits are compared to in-person visits, especially for new neurology patients. We looked at how often people had a follow-up neurology clinic visit or needed to go to the emergency department or the hospital within three months after their first visit to see if virtual visits led to a need for more follow-up evaluations or more serious problems than in-person visits."

Chloé E. Hill, MD, study author of the University of Michigan in Ann Arbor and member of the American Academy of Neurology

For the study, researchers reviewed electronic medical record data from three academic health systems to identify first-time patient visits with a neurology clinician between September 2020 and December 2021, during the COVID-19 pandemic.

Researchers matched 8,202 virtual visits to 8,202 in-person visits. Participants were matched for factors such as age, sex and previous health care use. They were then grouped into categories based on the reason for their visit, such as dementia, epilepsy, headache, peripheral neuropathy, Parkinson's disease, multiple sclerosis, stroke, sleep disorders and other conditions.

Comparing virtual visits and in-person visits, researchers found no difference in follow-up visits to a neurology clinic, either virtual or in-person, with a quarter of people having a second visit within 90 days.

Visits to the emergency department and hospitalizations were also similar within 90 days.

When looking at individual conditions, the 90-day clinic visit follow-up rate was higher after in-person visits for dementia, while 30- and 90-day follow-up was higher after virtual visits for Parkinson's disease and multiple sclerosis, and 90-day follow-up was higher after virtual visits for headache. In stroke, there were more hospitalizations within 90 days following a virtual visit.

"Our results suggest that virtual visits are appropriate for an initial neurologic evaluation across a range of conditions," said Hill. "We found that neurology patients with initial virtual visits do not typically experience higher rates of trips to the emergency department or hospitalizations. Future research should investigate more fully if people with different conditions may benefit more from one particular type of visit."

A limitation of the study was that the data was from the early months of the COVID-19 pandemic before a vaccine was available and when care‑seeking behavior may have been affected. Hill said more recent years of data may show different patterns of medical care use and should be analyzed in future studies.

The study was supported by the American Academy of Neurology.