Kelly Harper1, Megan McLeod2, Summer K Brown3, Georgia Wilson4, Maxim Turchan5, Emily M Gittings6, Derek Riebau7, Mark Baker8, Eli Zimmerman9, David Charles10. 1. Vanderbilt University Medical Center, Nashville, Tennessee, USA kelly.a.harper@vanderbilt.edu. 2. University of Mississippi, Oxford, Mississippi, USA memcleod@go.olemiss.edu. 3. Vanderbilt University, Nashville, Tennessee, USA summer.k.brown@vanderbilt.edu. 4. Department of Neurology, Vanderbilt University Medical Center, Nashville, Tennessee, USA georgia.j.wilson@vanderbilt.edu. 5. Vanderbilt University Medical Center, Nashville, Tennessee, USA maxim.turchan@vanderbilt.edu. 6. McGill University, Montreal, Canada gittings.em@gmail.com. 7. Vanderbilt University Medical Center, Nashville, Tennessee, USA derek.a.riebau@vanderbilt.edu. 8. Vanderbilt University Medical Center, Nashville, Tennessee, USA mark.d.baker@vanderbilt.edu. 9. Vanderbilt University Medical Center, Nashville, Tennessee, USA eli.zimmerman@vanderbilt.edu. 10. Vanderbilt University Medical Center, Nashville, Tennessee, USA david.charles@vanderbilt.edu.
Abstract
INTRODUCTION: This study aimed to demonstrate that teleneurology consultations conducted via tablet technology are an efficient and cost-effective means of managing acute neurologic emergencies at community-based hospitals and that utilizing such technology yields high community physician satisfaction. METHOD: During a 39-month period, Vanderbilt University Medical Center in Tennessee USA, provided teleneurology services to 10 community-based hospitals that lacked adequate neurology coverage. Hospitalists at one community-based hospital were not comfortable treating any patient with a neurologic symptom, resulting in 100% of those patients being transferred. This facility now retains more than 60% of neurology patients. For less than US$1200, these hospitals were able to meet the only capital expenditure required to launch this service: the purchase of handheld tablet computers. Real-time teleneurology consultations were conducted via tablet using two-way video conferencing, radiologic image sharing, and medical record documentation. Community physicians were regularly surveyed to assess satisfaction. RESULTS: From February 2014 to May 2017, 3626 teleneurology consultations were conducted. Community physicians, in partnership with neurologists, successfully managed 87% of patients at the community-based hospital. Only 13% of patients required transfer to another facility for a higher level of care. The most common diagnoses included stroke (34%), seizure (11%), and headache/migraine (6%). The average time for the neurologist to answer a request for consultation page and connect with the community physician was 10.6 minutes. Ninety-one percent of community physicians were satisfied or somewhat satisfied with the overall service. CONCLUSION: In the assessment of neurology patients, tablets are a more cost-effective alternative to traditional telehealth technologies. The devices promote efficiency in consultations through ease of use and low transfer rates, and survey results indicate community physician satisfaction.
INTRODUCTION: This study aimed to demonstrate that teleneurology consultations conducted via tablet technology are an efficient and cost-effective means of managing acute neurologic emergencies at community-based hospitals and that utilizing such technology yields high community physician satisfaction. METHOD: During a 39-month period, Vanderbilt University Medical Center in Tennessee USA, provided teleneurology services to 10 community-based hospitals that lacked adequate neurology coverage. Hospitalists at one community-based hospital were not comfortable treating any patient with a neurologic symptom, resulting in 100% of those patients being transferred. This facility now retains more than 60% of neurology patients. For less than US$1200, these hospitals were able to meet the only capital expenditure required to launch this service: the purchase of handheld tablet computers. Real-time teleneurology consultations were conducted via tablet using two-way video conferencing, radiologic image sharing, and medical record documentation. Community physicians were regularly surveyed to assess satisfaction. RESULTS: From February 2014 to May 2017, 3626 teleneurology consultations were conducted. Community physicians, in partnership with neurologists, successfully managed 87% of patients at the community-based hospital. Only 13% of patients required transfer to another facility for a higher level of care. The most common diagnoses included stroke (34%), seizure (11%), and headache/migraine (6%). The average time for the neurologist to answer a request for consultation page and connect with the community physician was 10.6 minutes. Ninety-one percent of community physicians were satisfied or somewhat satisfied with the overall service. CONCLUSION: In the assessment of neurology patients, tablets are a more cost-effective alternative to traditional telehealth technologies. The devices promote efficiency in consultations through ease of use and low transfer rates, and survey results indicate community physician satisfaction.
Authors: Jasvinder A Singh; John S Richards; Elizabeth Chang; Amy Joseph; Bernard Ng Journal: Arthritis Care Res (Hoboken) Date: 2021-07 Impact factor: 4.794