Provider Experience with Teleneurology in an Academic Neurology Department

Abstract

Introduction: Teleneurology has become widely adopted during severe acute respiratory syndrome coronavirus 2 pandemic. However, provider impressions about the teleneurology experience are not well described. Methods: A novel questionnaire was developed to collect provider impressions about video teleneurology encounters. All providers in the University of Pennsylvania Health System (UPHS) Neurology Department (N = 162) were asked to complete a questionnaire after each video teleneurology patient encounter between April and August 2020. Individual patient and encounter-level data were extracted from the electronic medical record. Results: One thousand six hundred three surveys were completed by 55 providers (response rate of 10.12%). The history obtained and the ability to connect with the patient were considered the same or better than an in-person visit in almost all encounters. The quality of the physician-patient relationship was good or excellent in 93%, while the overall experience was the same as an in-person visit in 73% of visits and better in 12%. Sixty-eight percent of respondents reported that none of the elements of the neurological examination if performed in person would have changed the assessment and plan. Assessment of the visit as the same or better increased from 83% in April to 89% in July and 95% in August. Headache (91%), multiple sclerosis and neuroimmunology (96%), and movement disorder (89%) providers had the highest proportion of ratings of same or better overall experience and neuromuscular providers the lowest (60%). Conclusions: Provider impressions about the teleneurology history, examination, and provider-patient relationship are favorable in the majority of responses. Important differences emerge between provider specialty and visit characteristics groups.

Keywords: provider; quality improvement; telemedicine; teleneurology.

Fig. 1.

Teleneurology visits and provider impressions across the University of Pennsylvania Hospital System. (A) Completed outpatient visits per week in the University of Pennsylvania Health System (UPHS) Department of Neurology between March and August 2020. Black line represents the initiation of the provider survey. New and established patient visits are included. (B) Summary responses from all completed video visits (N = 1,620). (C) Provider impressions about the teleneurology examination. Responses are number of affirmative responses (% of total responses). Multiple selections were possible.