Department of Neurology, University of Pittsburgh Medical School and University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
JAMA Neurol. 2015 Mar;72(3):349-54. doi: 10.1001/jamaneurol.2014.3844.
The growing disparity between the demand for neurological services and the need for neurologists requires new and innovative strategies for delivering care. Teleneurology allows neurological expertise to be delivered to remote locations to supplement or replace in-person neurological care.
To summarize the current status of teleneurology. Applications of teleneurology include acute care, outpatient teleneurology, and teleconsultations. Existing barriers to further expansion of teleneurology are also discussed.
Published studies pertaining to teleneurology were reviewed. Practical experience with telemedicine in neurological practice contributed to the conclusions.
Outcomes after intravenous tissue plasminogen activator treatment via telemedicine (telestroke) are similar to those achieved with in-person evaluations. Other aspects of teleneurology are less established but have demonstrated feasibility, high patient satisfaction, and, in some cases, cost savings.
Teleneurology provides neurological expertise to rural areas with limited availability of neurologists and improves care for patients with difficulty traveling owing to neurological disease. It is likely that use of teleneurology will continue to grow and become incorporated into many aspects of neurological practice. Understanding the advantages and limitations of teleneurology is vital to delivering optimal clinical care for patients with neurological disease regardless of the setting.
神经科服务的需求与神经科医生之间的差距不断扩大，这需要新的和创新的策略来提供护理。远程神经病学可以将神经科专业知识送到远程地点，以补充或替代面对面的神经科护理。
总结远程神经病学的现状。远程神经病学的应用包括急性护理、门诊远程神经病学和远程咨询。还讨论了进一步扩大远程神经病学的现有障碍。
审查了与远程神经病学相关的已发表研究。神经病学实践中远程医疗的实际经验促成了这些结论。
通过远程医疗（远程卒中）进行静脉组织型纤溶酶原激活剂治疗后的结果与面对面评估相似。远程神经病学的其他方面尚未得到充分确立，但已证明具有可行性、患者满意度高，在某些情况下还可以节省成本。
远程神经病学为神经科医生有限的农村地区提供了神经科专业知识，并改善了因神经系统疾病而难以出行的患者的护理。远程神经病学的使用很可能会继续增长，并融入神经病学实践的许多方面。了解远程神经病学的优势和局限性对于无论在何种环境下为患有神经系统疾病的患者提供最佳临床护理都至关重要。
