Tailoring teleconsultation to meet the current needs of neurosurgical services: a multimodality oriented neurosurgical consultation.

Teleconsultation in Neurosurgery was introduced in Malaysia in 2006 with the aims of enhancing quality services in the field of Neurosurgery. The present teleconsultation system is equipped with user friendly features which allow physicians to send and neurosurgeons to gain access to patient data in a swift and effective manner. In the past, teleconsultation in neurosurgery was tied with teleradiology, however we have now developed a multimodality system to cater specifically for neurosurgery. In Malaysia, the teleconsultation service is gaining momentum as evidenced by the large volume of cases channeled through this system. 944 cases within a span of 4 months were recorded on the system. 54.5% of the cases were trauma, 33.2% stroke, 6.1% intracranial tumours, 2% of cases were of spinal pathology, 2% pediatric anomalies and 2.2% intracranial infections. 50.2% of the referrals were after regular working hours reflecting the need for dedicated teleneurosurgery consultative services and the ability to review referrals outside of hospitals. Only 36% of cases needed emergency transfers and 9.9% of the cases were managed remotely at distant hospitals. Another 9.4% of the cases were either transferred electively or brought to the clinic for consultation. The above findings emphasise the importance of teleconsultation as a means to provide wide medical coverage within the region.