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Review
. 2013 Feb 12;80(7):670-6.
doi: 10.1212/WNL.0b013e3182823361.

Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology

Lawrence R Wechsler  1 , Jack W Tsao, Steven R Levine, Rebecca J Swain-Eng, Robert J Adams, Bart M Demaerschalk, David C Hess, Elena Moro, Lee H Schwamm, Steve Steffensen, Barney J Stern, Steven J Zuckerman, Pratik Bhattacharya, Larry E Davis, Ilana R Yurkiewicz, Aimee L Alphonso; American Academy of Neurology Telemedicine Work Group
Affiliations
Review

Teleneurology applications: Report of the Telemedicine Work Group of the American Academy of Neurology

Lawrence R Wechsler et al. Neurology. .

Abstract

Objective: To review current literature on neurology telemedicine and to discuss its application to patient care, neurology practice, military medicine, and current federal policy.

Methods: Review of practice models and published literature on primary studies of the efficacy of neurology telemedicine.

Results: Teleneurology is of greatest benefit to populations with restricted access to general and subspecialty neurologic care in rural areas, those with limited mobility, and those deployed by the military. Through the use of real-time audio-visual interaction, imaging, and store-and-forward systems, a greater proportion of neurologists are able to meet the demand for specialty care in underserved communities, decrease the response time for acute stroke assessment, and expand the collaboration between primary care physicians, neurologists, and other disciplines. The American Stroke Association has developed a defined policy on teleneurology, and the American Academy of Neurology and federal health care policy are beginning to follow suit.

Conclusions: Teleneurology is an effective tool for the rapid evaluation of patients in remote locations requiring neurologic care. These underserved locations include geographically isolated rural areas as well as urban cores with insufficient available neurology specialists. With this technology, neurologists will be better able to meet the burgeoning demand for access to neurologic care in an era of declining availability. An increase in physician awareness and support at the federal and state level is necessary to facilitate expansion of telemedicine into further areas of neurology.

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Conflict of interest statement

L. Wechsler has served as a consultant for Abbott Vascular, Lunbeck, and Ferrer; is on the Data and Safety Monitoring Board for DIAS 3/4/J and the steering committee for CLOSURE, ACT I; and owns stock in Neurointerventional Therapeutics. J. Tsao has received funding from the Telemedicine and Advanced Technology Research Center, United States Army, to develop a military neurology telemedicine system. S. Levine has given expert review and testimony on medical legal cases and has received research funding from the NIH. R. Swain-Eng is a full-time employee of the American Academy of Neurology. R.J. Adams is cofounder of REACHCall Inc., a for-profit telemedicine platform provider. He is also a co-owner of the company with <5% of outstanding stock. He is employed by Medical University of South Carolina, which offers telestroke consultation for fair market value to hospitals in South Carolina. He also is a speaker for Genentech, which makes tPA, but owns no stock. B. Demaerschalk has received telemedicine research grant funding from the Arizona Department of Health Services. Dr. Hess is a cofounder of REACHCall Inc., a for-profit telemedicine platform provider. He is also a co-owner of the company with <5% of outstanding stock. He is employed by Georgia Health Sciences University, which offers telestroke consultation for fair market value to hospitals in Georgia. He also has research contracts with Athersys, Inc., and Lundbeck. E. Moro has received honoraria from Medtronic for consulting services and speaking. She has received research grant support from St. Jude Medical and educational grants from Medtronic and St. Jude Medical. L. Schwamm serves as a consultant to LifeImage, a teleradiology company, and on the International Steering Committee for the DIAS3/4 trial. His employer, The Massachusetts General Hospital, offers an array of telehealth services at fair market value to many area hospitals, including telestroke. He has also given expert review and testimony on medical legal cases and has received research funding from the NIH on thrombolysis and HRSA on telemedicine. S. Steffensen reports no disclosures. B. Stern has received research support from Remedy Pharmaceuticals per patient research costs and research grants from the NIH. He has also received compensation for expert witness testimony. S. Zuckerman and P. Bhattacharya report no disclosures. L. Davis is a part of the VA Teleneurology group for which the VA pays part of the research costs for the nursing staff. I. Yurkiewicz and A. Alphonso report no disclosures. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Navy, the Department of Defense, or the Department of Veterans Affairs. Go to Neurology.org for full disclosures.

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