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Sarah E Velasquez, Enrique Chaves-Carballo, Eve-Lynn Nelson
BACKGROUND: Approximately 2.7 million individuals in the United States are affected by epilepsy. It is the fourth most common neurological disorder and affects people of all ages, races, and economic backgrounds. In many rural states, the few pediatric neurologists commonly practice in the metropolitan areas. The inadequate resources present challenges for families residing in rural areas or with limited transportation resources. One remedy for this situation is to deliver pediatric neurology services to rural areas through videoconferencing...
August 10, 2016: Pediatric Neurology
Gary H Belt, Robert A Felberg, Jane Rubin, John J Halperin
BACKGROUND AND PURPOSE: Time to treatment is critically important in ischemic stroke. We compared the efficacy and cost of teleneurology evaluation during patient transport with that of mobile stroke transport units. METHODS: Using cellular-connected telemedicine devices, we assessed 89 presumptive stroke patients in ambulances in transit. Paramedics assisted remote teleneurologists in obtaining a simplified history and examination, then coordinating care with the receiving emergency department...
September 2016: Stroke; a Journal of Cerebral Circulation
Antonio Jose Reyes, Kanterpersad Ramcharan
We report a patient driven home care system that successfully assisted 24/7 with the management of a 68-year-old woman after a stroke-a global illness. The patient's caregiver and physician used computer devices, smartphones and internet access for information exchange. Patient, caregiver, family and physician satisfaction, coupled with outcome and cost were indictors of quality of care. The novelty of this basic model of teleneurology is characterised by implementing a patient/caregiver driven system designed to improve access to cost-efficient neurological care, which has potential for use in primary, secondary and tertiary levels of healthcare in rural and underserved regions of the world...
2016: BMJ Case Reports
Seby John, Sarah Stock, Thomas Masaryk, Andrew Bauer, Russell Cerejo, Ken Uchino, Stacey Winners, Peter Rasmussen, Muhammad S Hussain
BACKGROUND: There is a strong inverse relationship between outcome in patients with acute ischemic stroke from emergent large vessel occlusion (ELVO), and time to reperfusion from intra-arterial therapy. Delay in transferring patients to thrombectomy-capable centers is currently a major limitation. The mobile stroke unit (MSU) concept with onboard portable computed tomography (CT) scanner enables rapid performance of CT angiography (CTA) of the intracranial vessels to detect ELVO in the field, and allows for rapid triage of patients to interventional-capable centers...
July 2016: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
Maryam Bashiri, L John Greenfield, Alison Oliveto
BACKGROUND: Teleneurology in Arkansas has been used primarily for management of acute stroke with a state-funded hub-and-spoke model allowing physicians at rural hospitals to access vascular neurologists in time to facilitate tissue plasminogen activator administration. Routine neurologic care has been provided only in small pilot studies. We wished to determine patient interest in participating in teleneurology for routine follow-up visits as well as demographic and medical factors associated with interest...
June 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Sunil A Mutgi, Alicia M Zha, Reza Behrouz
No abstract text is available yet for this article.
June 2, 2015: Neurology
Kate E Klein, Peter A Rasmussen, Stacey L Winners, Jennifer A Frontera
Telestroke and teleneurologic intensive care units (teleneuro-ICUs) optimize the diagnosis and treatment of neurologic emergencies. Establishment of a telestroke or teleneuro-ICU program relies on investment in experienced stroke and neurocritical care personnel as well as advanced telecommunications technologies. Telemanagement of neurologic emergencies can be standardized to improve outcomes, but it is essential to have a relationship with a tertiary care facility that can use endovascular, neurosurgical, and neurocritical care advanced therapies after stabilization...
April 2015: Critical Care Clinics
Lawrence R Wechsler
IMPORTANCE: The growing disparity between the demand for neurological services and the need for neurologists requires new and innovative strategies for delivering care. Teleneurology allows neurological expertise to be delivered to remote locations to supplement or replace in-person neurological care. OBJECTIVE: To summarize the current status of teleneurology. Applications of teleneurology include acute care, outpatient teleneurology, and teleconsultations. Existing barriers to further expansion of teleneurology are also discussed...
March 2015: JAMA Neurology
Karen Greenberg, Christina R Maxwell, Keisha D Moore, Michael D'Ambrosio, Kenneth Liebman, Erol Veznedaroglu, Geri Sanfillippo, Cynthia Diaz, Mandy J Binning
BACKGROUND: The neurologic emergency department (neuro ED) at our medical center is staffed by emergency medicine physicians who have specialized neuroscience training and give intravenous (IV) tissue plasminogen activator (tPA) independently for acute ischemic stroke patients. Door-to-needle (DTN) times, discharge location, and discharge National Institute of Health Stroke Scale (NIHSS) scores were studied between the neuro ED and main emergency department (ED) with the hypothesis that all measures would be better in the neuro ED group...
February 2015: American Journal of Emergency Medicine
Neha M Kramer, Bart M Demaerschalk
BACKGROUND: Telemedicine is used for specialist consultation, patient evaluation, and remote monitoring. We propose that telemedicine has a valuable role in medical education through facilitating faculty supervision of trainees. MATERIALS AND METHODS: We surveyed resident physician trainees and faculty at a single institution who provided service for acute neurologic consultations over 29 months. The survey compared experiences using the supervisory methods of telephone, robotic telepresence (RTP), and in-person interaction...
December 2014: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
René Handschu, Mateusz Scibor, Martin Nückel, Dirk Asshoff, Barbara Willaczek, Frank Erbguth, Stefan Schwab, Frank Daumann
Telemedicine is in increasing use in clinical neuroscience such as acute stroke care, especially by applying remote audiovisual communication for patient evaluation. However, telephone consultation was also used linking stroke centres to smaller hospitals. We compared costs of telestroke services using audiovisual and telephone communication in different organizational models. Within a small network in Northern Bavaria video-based teleconsultation (VTC) and telephone advice (TA) was provided for evaluation of acute stroke patients on a weekly rotation...
October 2014: Journal of Neurology
Larry E Davis, Julia Coleman, JoAnn Harnar, Molly K King
BACKGROUND: Delivery of specialty healthcare to rural citizens in the United States remains largely unmet. The Veterans Health Administration is in a unique position to deliver specialty care to rural Veterans because it is mandated to deliver medical care to all eligible Veterans regardless of residence. To accomplish this, the VHA developed large national telehealth networks that provided over 1 million episodes of care in 2012. We investigated whether clinical video telehealth technologies can provide quality efficient neurologic follow-up care to Veterans living in the rural southwest United States...
May 2014: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Mark N Rubin, Kay E Wellik, Dwight D Channer, Bart M Demaerschalk
The use of 2-way audiovisual telemedicine technology for the delivery of acute stroke care is well established in the literature and is a growing practice. The use of such technology for neurologic consultation outside the cerebrovascular specialty has been reported to a variable extent across most disciplines within the field of neurology, including that of the neurohospitalist medicine. A systematic review of these reports is lacking. Hence, the main purpose of this study was to conduct a systematic review of the literature on teleneurologic consultation in hospital neurology...
July 2013: Neurohospitalist
William David Freeman, Kevin M Barrett, Kenneth A Vatz, Bart M Demaerschalk
Despite the growing demand for emergency neurological evaluations and neurohospitalists, the supply of neurologists remains relatively fixed over time.  Telemedicine is a unique tool that has the ability to put a medical specialist like a neurologist in 2 places in a relatively short period of time, expanding expertise in many rural and in some underserved urban facilities that would ordinarily be devoid of such expertise. Teleneurology is a branch of telemedicine that consults and practices through remote neurological evaluation...
October 2012: Neurohospitalist
William D Freeman, Kenneth A Vatz, Robert C Griggs, Timothy Pedley
The American Academy of Neurology Workforce Task Force (WFTF) report predicts a future shortfall of neurologists in the United States. The WFTF data also suggest that for most states, the current demand for neurologist services already exceeds the supply, and by 2025 the demand for neurologists will be even higher. This future demand is fueled by the aging of the US population, the higher health care utilization rates of neurologic services, and by a greater number of patients gaining access to the health care system due to the Patient Protection and Affordable Care Act...
July 30, 2013: Neurology
Mark N Rubin, Kay E Wellik, Dwight D Channer, Bart M Demaerschalk
Remote consultation via telemedicine for neurologic indications is in the mainstream. This holds most true for cerebrovascular concerns such as acute stroke, but its use has extended into most of the breadth of neurologic subspecialty practice. This is ostensibly a major advance for enhancing access to neurologic specialty care and a path toward better outcomes overall. Currently, there is a lack of randomized controlled trials and health economic analyses to support this conclusion. The continued use and expansion of teleneurologic practice is encouraged, so long as it is accompanied by clinical data tracking and leads to more randomized controlled trials...
October 2013: Current Treatment Options in Neurology
Francesca Timpano, Lilla Bonanno, Alessia Bramanti, Fabio Pirrotta, Letteria Spadaro, Placido Bramanti, Pietro Lanzafame
Emerging information and communication technology is changing medical and psychological practice by enabling the provision of services across time and distance, yet there are significant concerns about these applications. Given the emerging nature of trial evidence in teleneurology, our aim is to provide a narrative review, in order to investigate possible oncoming fields of applications that are very important in healthcare practices delivered to patients affected by neurological diseases. We will focus on the use of Tele-Health in neurological practice, highlighting the potential benefits of applying information and communication technology also to psychosocial and educational aspects of neurological diseases treatment...
December 2013: Neurological Sciences
Lawrence R Wechsler, 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
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...
February 12, 2013: Neurology
Mark N Rubin, Kay E Wellik, Dwight D Channer, Bart M Demaerschalk
BACKGROUND: The use of two-way audio-visual technology for delivery of acute stroke is supported by a well established literature base. The use of telemedicine for general neurologic consultation has been reported across most subspecialties within the field, but a comprehensive systematic review of these reports is lacking. PURPOSE: To conduct a systematic review of the published literature on teleneurologic consultation beyond stroke. DATA SOURCES: Databases Ovid MEDLINE, EMBASE, PsychINFO, CINAHL, and Cochrane were searched with keywords, "teleneurology," and numerous synonyms and cross-referenced with neurology subspecialties...
2012: Frontiers in Neurology
Parashkev Nachev
No abstract text is available yet for this article.
December 2012: Journal of Neurology, Neurosurgery, and Psychiatry
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