“The concept of ‘going to the doctor’ is becoming just one modality for accessing care”. Words of Dr. Wechsler seem relevant in the current scenario, doesn’t it?  With the rapid transition from avoiding visits to a hospital to availing of services online, the pandemic has changed the entire ball game. Especially when it comes to the ‘ most sceptic’ approach towards taking medical opinion and consulting doctors online for neurological conditions. The advent of Teleneurology may be recent but the transition and adoption of this form of consultation for brain and spine disorders are bringing comfort and a much required relieved to families across the globe. 

The What and How

So what is Teleneurology? It is a branch of telemedicine that offers consultations for neurological problems remotely to supplement in-person neurological care. This is primarily done through telephone or video call/conferencing. Waiting time = zero, access to care during the crucial time – check!

There are mainly two links used in Teleneurology. One is the synchronous link or a real-time consultation which is a two-way audio-visual link between a patient and a doctor present at the same time but not at the same place (live video-conferencing). The other is a store and forward links or an asynchronous link that involves acquiring medical data, then transmitting this data to the specialist at a convenient time for offline assessment (like emails).

Conditions that can be catered through Teleneurology

Neurologic issues, both urgent and non-urgent can be addressed through Teleneurology. The most popular one i.e., Telestroke has enabled doctors to deliver acute stroke treatment faster, safer and more often than before. 

Neurology telemedicine for acute stroke has already demonstrated clinical efficacy and cost-effectiveness by raising the numbers of thrombolysis-eligible patients who can be treated in a timely fashion. A case in 2012, where as soon as the patient was admitted to the hospital the primary care physician suspected acute stroke symptoms. He initiated a web conference with their expert neurologist who evaluated the patient’s condition and his CT scans, all online. Within 30 minutes (stroke is time-sensitive and every single minute is precious); a decision for injecting a clot-busting medicine (tPA) was made and the physician present took it through, saving the patient’s life and reducing the risk of permanent brain damage. 

Chronic neurological conditions such as headache, dementia, epilepsy, stroke, and movement disorders, and multiple sclerosis can be monitored through Teleneurology as well. For instance; a neurologist can gauge early symptoms of dementia by conducting cognitive measurement interviews via telephone or teleconferences in the presence of a patient’s family members. Early identification helps in determining proper treatment plans to mitigate risks and possibly delay progression. 

1 out of 100 people in India suffers from epilepsy so this form of telemedicine can work wonders for epileptic patients who often have difficulty in traveling. Now, nursing clinics will be able to offer better medication advice for their patients with the neurologist reviewing the EEG results using teleconferencing tools. 

Benefits 

Teleneurology allows patients to get their individualized care remotely for living lives to its fullest despite the progress of the neurodegenerative disease. Some other benefits are:

  • It reduces the average time of clinic/hospital stay
  • Makes the experience more comfortable in a home setting
  • Remove barriers to a medical facility due to distance, disability, mobility, anxiety, and impairments
  • Tele neurology visits are more prompt and focused
  • Provides access to ‘specialist and super specialists’ for follow-up care

Advances And Limitation Of TeleNeurology

In the words of Levine “Teleneurology is the next best thing, but it is not the best thing.” His words hold true in this context, despite various benefits; Teleneurology possesses the limitation of ‘hands-on- examination’ that is required in certain cases. For example, a subtle nystagmus (reflexes and muscle tone test) examination cannot be performed virtually. But with the global proliferation of technology, neurological care and remote education with the utilization of this upcoming technology, has the potential to enhance and increase access to medical care for billions of people in the country. 

The Telemedicine Society of India is contributing to creating much-needed awareness regarding Teleneurology to make it an integral part of our health care delivery system. And all we need is a change in our mindset towards the adoption of Telehealth so, that every individual can avail of its benefits on time. 

Conclusion

It’s time to leverage the flexibility of telehealth from home during the COVID 19 pandemic and beyond it as well. Teleneurology provides a high standard of care, offers the best possible treatment options, helps in managing prescriptions, and coordinates neurologic care plans with family, caregivers, and other physicians. But, it is not the only or ultimate future of health care; it is how best we deliver the aspects of neurological care to our patients today in their comfort zone.

If you are looking to know how we deliver neuro care remotely, speak with our neurologists over a video /telecall and get your queries resolved right away! And don’t forget to check our Teleneurology talks here: https://youtu.be/9MCjIROd6yI