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E Ray Dorsey, Alistair M Glidden, Melissa R Holloway, Gretchen L Birbeck, Lee H Schwamm
Neurological disorders are the leading cause of global disability. However, for most people around the world, current neurological care is poor. In low-income countries, most individuals lack access to proper neurological care, and in high-income countries, distance and disability limit access. With the global proliferation of smartphones, teleneurology - the use of technology to provide neurological care and education remotely - has the potential to improve and increase access to care for billions of people...
April 6, 2018: Nature Reviews. Neurology
Ileana M Howard, Marla S Kaufman
Telehealth describes the provision of medical services remotely through technology, and may enhance patient access to specialty care services. Although teleneurology has expanded widely since the introduction of telestroke in 1999, telehealth services for outpatients with neuromuscular or musculoskeletal disorders are less widespread. In this narrative review, we will describe the current technology, applications, outcomes, and limitations of this dynamically growing field. Evidence for telehealth applications related to neuromuscular diseases, palliative care, specialized multidisciplinary services, and musculoskeletal care are reviewed...
March 6, 2018: Muscle & Nerve
Giuseppa Maresca, Maria C De Cola, Santina Caliri, Rosaria De Luca, Alfredo Manuli, Ileana Scarcella, Giuseppe Silvestri, Placido Bramanti, Michele Torrisi, Rocco S Calabrò, Alessia Bramanti
Introduction Elderly care is a worldwide social and economic challenge for the public health system, and it requires the development of new management strategies. Telemedicine provides an innovative approach towards elderly care, especially for those with chronic diseases. In this study, we aimed to evaluate the potential role of a multidisciplinary telemedicine approach for improving elderly quality of life. Methods Twenty-two participants received weekly vital parameter monitoring and nutritional counselling, biweekly psychological counselling and a monthly consultation with a neurologist...
January 1, 2018: Journal of Telemedicine and Telecare
Steven S Schreiber
BACKGROUND: The recent growth in telehealth has been facilitated by the need to deliver healthcare to patients living in remote or rural areas. In contrast, the role of telehealth in more urban settings is less clear. A teleneurology program was established in 2011 at the Tibor Rubin VA Medical Center (TRVAMC) in Long Beach, California. A review of teleneurology encounters was conducted to assess the feasibility of applying this telehealth modality to patients with chronic neurological disorders living in an urban setting...
January 5, 2018: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Fred S Sarfo, Sheila Adamu, Dominic Awuah, Bruce Ovbiagele
BACKGROUND: The rapid advancement in telecommunications on the African continent has opened up avenues for improving medical care to underserved populations. Although the greatest burden of neurological disorders is borne by Low-and-Middle Income Countries (LMICs) including sub-Saharan Africa (SSA), there is a profound paucity of neurologists to serve the population. Telemedicine presents a promising avenue for effective mobilization and utilization of the few neurologists in Africa. OBJECTIVE: To systematically review the published literature on the use of telemedicine for improved care and outcomes for patients with neurological disorders in SSA...
September 15, 2017: Journal of the Neurological Sciences
Raghav Govindarajan, Eric R Anderson, Roger R Hesselbrock, Ramesh Madhavan, Lauren R Moo, Nima Mowzoon, James Otis, Mark N Rubin, Madhu Soni, Jack W Tsao, Scott Vota, Hannah Planalp
The emerging field of teleneurology is delivering quality care to neurologic patients in increasingly numerous technologies and configurations. Teleneurology is well-positioned to address many of the logistical issues neurologists and their patients encounter today. However, formalized medical training has not caught up with this developing field, and there is a lack of formal education concentrating on the specific opportunities and challenges of teleneurology. Considering this, the American Academy of Neurology Telemedicine Work Group identified equivalencies with which any practitioner of teleneurology should be familiar...
August 29, 2017: Neurology
Altaf Saadi, Farrah J Mateen
Humanitarian emergencies defined by armed conflict, political strife, famine, or natural disaster can devastate populations rapidly. Neurologic disorders accompany these complex humanitarian emergencies but often go unheeded, exacerbated by a scarcity of neurologists. Teleneurology offers the promise of neurologic care remotely in the face of this inadequate local clinician supply. We describe our experiences as voluntary neurology teleconsultants with Médecins Sans Frontières in order to highlight both the promises and challenges of teleneurology in humanitarian contexts...
July 18, 2017: Neurology
Denise C Rhew, Susan H Owens, Jessica B Buckner, Sandra S Kueider
PROBLEM: For many stroke patients, rural emergency departments are the first point of medical care to stop brain cell death. We identified a need to meet standards to improve outcomes for stroke care. METHODS: An interdisciplinary Stroke Continuous Process Improvement Committee was formed. We conducted a gap analysis to address current stroke care processes. Chart audits were performed, and strategies to meet the requirements for recognition as an Acute Stroke Ready Hospital (ASRH) were implemented...
January 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
Fahad J Laghari, Maxim D Hammer
The use of telecommunications technology to provide the healthcare services, telemedicine, has been in use since the 1860s. The use of technology has ranged from providing medical care to far-off places during wartimes to monitoring physiological measurements of astronauts in space. Since the 1990s, reports have been published on diagnoses of neurological diseases with the use of video links. Studies confirm that the neurological examinations, including the National Institutes of Health Stroke Scale, performed during teleneurology are dependable...
January 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
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...
November 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...
August 2, 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
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