A growing shortage of neurologists means people who seek treatment for dementia, movement disorders, migraines and other neurologic disorders often face long wait times before they can get an appointment to see the doctor. But technology could speed up access to care.
A new report published in the journal Neurology finds video calls may be just as effective as in-office visits for those with a range of neurologic disorders.
Physicians have been using video technology to diagnose and treat stroke for several years. Knowing that “tele-evaluations are not inferior” to the traditional office visit for other neurologic conditions – ranging from concussion to epilepsy – could help more patients and physicians feel comfortable with the emerging field of telehealth, says Jaime Hatcher-Martin, a neurologist and the lead author on the report, which reviewed patient and physician satisfaction in more than 100 neurology-related telemedicine studies.
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Technology already plays a big role in the course of care for patients who need a neurologist but don't live close to one. Without telehealth, many simply wouldn't have a neurologist or would have to transfer to a hospital or clinic farther from work or family in order to routinely see one, Hatcher-Martin says. “But with telemedicine, [neurologists] can ‘be’ in Georgia at 9:30 a.m. and in Texas at 10 a.m.” to help these patients, she adds.
Connecting over video is also helpful for people with fast-progressing conditions that impact mobility, such as amyotrophic lateral sclerosis (ALS), says Rebecca Canino, administrative director for the Office of Telemedicine at Johns Hopkins. Patients can just as easily communicate and demonstrate changes in their condition through a video call to their doctor, without the hassle of leaving the house. Plus, allowing the doctor to see the patient “in the home setting” and to “see that difficulty in action” could result in faster, better care, Canino says.
"It actually allows the physician greater access to you, and you greater access to the physician,” she adds.
Telehealth is not meant to completely replace in-person appointments. Rather, it acts as “a tool that can help augment” care, Hatcher-Martin says. Still, some patients and physicians are hesitant to use it, fearing a less personal experience. She says this generally doesn't hold up, adding, “Many patients state they forget about the screen after a bit and feel like they are just talking in person.”
Physicians face additional barriers, including confusing reimbursement policies and laws that vary by state. Simplifying licensing and payment models, while also looking more into cost savings and patient outcomes could help push the field forward and extend specialized care to more people, Hatcher-Martin says.