1 Neurology Section, Tibor Rubin VA Medical Center , Long Beach, California.
2 Departments of Neurology, Anatomy and Neurobiology, Psychiatry and Human Behavior, UC Irvine School of Medicine , Irvine, California.
Telemed J E Health. 2018 Sep;24(9):698-701. doi: 10.1089/tmj.2017.0202. Epub 2018 Jan 5.
The recent growth in telehealth has been facilitated by the need to deliver healthcare to patients living in remote or rural areas. In contrast, the role of telehealth in more urban settings is less clear. A teleneurology program was established in 2011 at the Tibor Rubin VA Medical Center (TRVAMC) in Long Beach, California. A review of teleneurology encounters was conducted to assess the feasibility of applying this telehealth modality to patients with chronic neurological disorders living in an urban setting.
Teleneurology encounters were conducted by clinical video telehealth (CVT) between a provider at the TRVAMC and patients at local community-based outpatient clinics from November 2011 to December 2014. In a random sampling of veterans, they were asked to complete a patient satisfaction survey.
A total of 745 teleneurology encounters were performed including 570 unique patients. Veterans with a broad range of neurological disorders were seen, including Parkinson's disease, headaches, epilepsy, dementia, cerebrovascular disease, peripheral nervous system disorders, multiple sclerosis, and other problems such as dizziness and paresthesia. Compared with patients in face-to-face clinics, patients in teleneurology clinics consistently kept their appointments. Technical problems were rare and easily resolved. The majority of patients were satisfied with the care they received through teleneurology, and preferred CVT rather than a face-to-face encounter.
This report demonstrates the successful application of telehealth to evaluate and manage a diverse group of neurological disorders in an urban setting. Despite the relatively short distances involved, the majority of patients preferred telehealth over face-to-face encounters.
远程医疗的近期发展是由为居住在偏远或农村地区的患者提供医疗保健的需求所推动的。相比之下，远程医疗在更多城市环境中的作用则不太明确。2011 年，加利福尼亚州长滩的蒂博尔·鲁宾退伍军人事务医疗中心（TRVAMC）建立了远程神经病学项目。对远程神经病学就诊进行了回顾性研究，以评估将这种远程医疗模式应用于居住在城市环境中的慢性神经障碍患者的可行性。
2011 年 11 月至 2014 年 12 月，临床视频远程医疗（CVT）在 TRVAMC 的医务人员和当地社区门诊的患者之间进行远程神经病学就诊。随机抽样的退伍军人被要求完成患者满意度调查。
共进行了 745 次远程神经病学就诊，包括 570 名不同的患者。就诊的退伍军人患有各种神经疾病，包括帕金森病、头痛、癫痫、痴呆、脑血管疾病、周围神经系统疾病、多发性硬化症以及头晕和感觉异常等其他问题。与面对面诊所的患者相比，远程神经病学诊所的患者始终按时就诊。技术问题很少见，且易于解决。大多数患者对通过远程神经病学获得的护理感到满意，并更喜欢 CVT 而不是面对面就诊。
本报告证明了远程医疗在城市环境中成功应用于评估和管理各种神经疾病。尽管涉及的距离相对较短，但大多数患者更喜欢远程医疗而不是面对面就诊。
