Workgroup builds curriculum for teleneurology specialists

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An American Academy of Neurology workgroup has developed a curriculum to train students, resident physicians and other healthcare providers to use teleneurology in academic medicine environments and in private practice.

The workgroup’s curriculum has been endorsed by the American Telemedicine Association.

The use of teleneurology enables patients to have remote consultations with a neurologist and it’s seen as one way of alleviating the shortage of radiologists in this specialty.

The need for services is rising because the Affordable Care Act is helping more patients obtain health insurance in recent years and able to access care, increasing demand.

Rural and urban regions across the nation are facing shortages of neurologists, says Raghav Govindarajan, MD, an assistant professor of clinical neurology at the University of Missouri School of Medicine.

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“Through teleneurology, we’re able to virtually treat patients using technologies such as two-way video conferencing, wireless sensors, and text- and image-based communication,” Govindarajan explains in a study published in the journal Neurology. “This has shown tremendous promise and has already played a major role in acute stroke care. Despite this, teleneurology training in residency programs is currently non-existent, or is sporadic and inconsistent at best.”

The curriculum includes five competencies that providers must understand before practicing teleneurology:

• A strong foundation of technical knowledge is essential for safe and effective care. A provider must be comfortable with using technology to review patient medical records, move cameras and perform other functions, including troubleshooting technology issues that arise.

• Licensing requirements vary across states and are always evolving. Practitioners must have a foundational understanding of the requirements to avoid legal ramifications.

• Providers must develop “website” manners to enhance the provider-patient relationship in face-to-face visits. A video screen and camera can make this difficult and a physician must overcome this barrier to connect with the patient.

• Informed consent, patient privacy and disclosure must be part of the video teleconsultation. Neurologists must inform patients that the security of their personal data is in accordance with the HIPAA and HITECH acts.

• Neurologists conducting remote consultations should have specific clinical skills that ensure patients receive the same standard of care they would get with an in-person provider.

“Unfortunately, teleneurology is akin to the Wild West,” Govindarajan concludes. “Many practitioners may be operating without the necessary skills and expertise to best care for the patient. Our outline is meant to be an evolving document that will continue to be adapted to best practices in the field.

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