Implementation and Patient Experience with Outpatient Subspecialty Teleneurology Visits at a Single Academic Institution Over Four Years

Objective: To describe the implementation and patient experience with outpatient subspecialty teleneurology visits at an academic institution over four years. Background: Teleneurology has been well described for acute stroke but its outpatient use has been limited. In particular, there are few studies assessing personal use video-conferencing platforms in neurology. At home virtual visits have the potential to improve patient access to neurological subspecialty care which otherwise often requires travel. Travel may be difficult for patients due to expense and disability. There is a need for improved access to quality neurological care. Design/Methods: All adult patients completing virtual neurologic follow-up visits from a single tertiary care institution over a four year period were included. Virtual visits were conducted by personal smartphone or computer via video-conferencing with a provider. Patients were asked to rate their overall experience with the visit and provider (5 point scale). Travel distance from the institution was calculated using patient’s home address. Results: 3958 patients completed 5646 virtual visits during the four year period. Virtual visits were completed in all outpatient subspecialities with breakdown as follows: Headache 21.4%, Epilepsy 19.1%, Spine 15.7%, Movement 10.8%, Psychiatry 6.4%, Autonomic 5.7%, Cerebrovascular 4.8%, Cognitive 3.6%, and the remainder being 270 miles). Across the 5646 visits, 1,418,688 miles of travel was prevented. Number of virtual visits increased from 30 visits year 1 to 4514 year 4. 25.1% of patients completed multiple virtual visits. On average, patients rated their overall experience with the virtual visit 4.7/5 and rated their provider 4.9/5. Conclusions: This study demonstrates the feasibility of implementing subspecialty teleneurology services and high patient ratings for these services. Future efforts should focus on demonstrating value for patients and the health care system. Disclosure: Dr. Ross has nothing to disclose. Dr. Bena has nothing to disclose. Dr. Bermel has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Biogen, Genzyme, Genentech, Novartis, Roche. Dr. Bermel has received research support from Biogen, Genentech, Roche. Dr. McCarter has nothing to disclose. Dr. Ahmed has nothing to disclose. Dr. Goforth has nothing to disclose. Dr. Cherian has nothing to disclose. Dr. Kriegler has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with DynaMed Plus. Dr. Kriegler has received research support from Allergan and Amgen. Dr. Estemalik has nothing to disclose. Dr. Stanton has nothing to disclose. Dr. Rasmussen has nothing to disclose. Dr. Fernandez has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Prime Education Inc. International Parkinson and Movement Disorders Society, Carling Communications, Medscape, Vindico, AbbVie, Biogen, Blackthorn, Inventiv, Kyowa Hakko Kirin, Medscape, Voyager, Sunovion, and Pfizer Pharmaceuticals. Dr. Fernandez has received royalty, license fees, or contractual rights payments from Demos Publishing, Cambridge University Press. Dr. Fernandez has received research support from Abbvie, Biotie/Acorda Therapeutics, Michael J. Fox Foundation, Movement Disorders Society, NIH/NINDS, Parkinson Study Group, Rhythm, Sunovion. Dr. Najm has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Eisai. Dr. McGinley has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Sanofi Genzyme and Genentech.