The coronavirus disease 2019 (COVID-19) outbreak has brought telemedicine into a new light with a rapid increase in the use of telemedicine and a recent viewpoint published in JAMA Neurology focused on the remote care of patients with chronic neurological disorders.

Bastiaan R. Bloem, MD, PhD, medical director of the Department of Neurology at Radboud University Medical Center, Nijmegen, the Netherlands explained that in light of the strong recommendation to avoid outpatient visits if possible, there has been a growing understanding that chronic neurological care can be safely delivered remotely and may be best delivered as close to the patients home as possible.

Episodic outpatient visit often provide an unrealistic perspective of the patients status and are not a reliable tool to identify rare complications or assess treatment outcomes that can fluctuate over time. On the other hand, home visits provide confidentiality, have the advantage of assessing the patients natural environment and can prevent the risks associated with long travels to the hospitals.

Telemedicine approaches can include videoconferencing for remote consultations, as well as remote monitoring using sensors that can be passive (occurring in the background) or active (asking patients to completed scheduled tasks).

Despite the potential advantages of telemedicine, it was not successful as anticipated with many stating that making a change in healthcare is a challenging task. However, the current COVID-19 global crisis has accelerated the use of telemedicine and remote consultation is becoming an increasingly attractive option across many healthcare systems. The experience of many patients and families has also been positive.

While previously there were many concerns regarding the use of telemedicine, the current crisis and the rise in telemedicine has helped to overcome many of the earlier objections against its use as it was shown that a simple neurological assessment can be performed remotely, the success was not limited to young patients but was also shown in many older adults, and reimbursement mechanisms were successfully implemented.

However, there are also challenges associated with this rapid rise in telemedicine, such as issues regarding privacy, security and participants confidentiality.

Telemedicine for chronic neurological disorders should become part of the new normal rather than the exception. Governments, health care systems, and payers should be encouraged to continue to embrace the new age of access from home, even after the pandemic passes, concluded Bloem.

Reference

Bloem BR, Dorsey ER, Okun MS. The Coronavirus disease 2019 crisis as catalyst for telemedicine for chronic neurological disorders [published online ahead of print, 2020 Apr 24]. JAMA Neurol. doi:10.1001/jamaneurol.2020.1452

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COVID-19 and the Rise of Telemedicine for Chronic Neurological Disorders - Neurology Advisor