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通过基于视频的远程神经心理学改变儿科神经心理学:新冠疫情前的一种创新的私人执业模式。

Transforming pediatric neuropsychology through video-based teleneuropsychology: an innovative private practice model pre-COVID-19.

机构信息

Neuropsychology Concierge®, Indialantic, FL, USA.

Departments of Psychiatry and Pediatrics, The University of Texas Southwestern Medical Center, Dallas, FL, USA.

出版信息

Arch Clin Neuropsychol. 2020 Nov 19;35(8):1189-1195. doi: 10.1093/arclin/acaa101.

Abstract

OBJECTIVE

In pediatric neuropsychology multiple barriers such as long wait times until an appointment, insurance coverage, and limited providers who are bilingual/bicultural or who sub-specialize in pediatric neuropsychology, often slow families from receiving diagnoses and interventions in a timely and affordable manner. This paper focuses on increasing accessibility through the development of a video-based, pediatric teleneuropsychology (TeleNP) practice model that was developed in a private practice 2 years before the COVID-19 pandemic.

METHOD

'Design thinking' methodology to problem-solving was utilized to innovate the traditional neuropsychology practice model in under-served areas who may have limited financial and healthcare resources. The practice model approach to include a virtual diagnostic clinic with increased patient and provider efficiency was created to enhance accessibility for patients and sustainability for providers.

RESULTS

Video-based TeleNP screenings were conducted for 67 children with developmental (i.e., attention deficit hyperactivity disorder, autism spectrum disorder) and language disorders, as well as concussion and psychiatric diagnoses. Additional comorbidities were identified in 65.6% of children. Follow-up data approximately 2 months later revealed 98.5% of children were receiving new interventions as a result of the video-based TeleNP assessment.

CONCLUSION

Video-based TeleNP benefits the consumer as it can reduce wait times, decrease family financial burden (i.e., travel and parent time off work), expedite referrals for interventions, and provide geographically under-served populations access to providers who are linguistically and culturally responsive. For providers, this model revealed improvements with direct implications for cost-saving, thereby facilitating long-term economic sustainability within a private practice healthcare marketplace.

摘要

目的

在儿科神经心理学领域,存在多种障碍,如预约等待时间长、保险覆盖范围有限,以及双语/双文化或专门从事儿科神经心理学的双语提供者有限等,这些因素常常导致家庭无法及时、经济地获得诊断和干预。本文重点介绍了一种通过开发基于视频的儿科远程神经心理学(TeleNP)实践模型来增加可及性的方法,该模型是在 COVID-19 大流行之前的 2 年前在一家私人诊所开发的。

方法

利用“设计思维”方法解决问题,对服务不足地区的传统神经心理学实践模式进行创新,这些地区可能有限的财务和医疗资源。创建了一种包含虚拟诊断诊所的实践模型方法,以提高患者和提供者的效率,从而增强患者的可及性和提供者的可持续性。

结果

对 67 名患有发育障碍(例如注意力缺陷多动障碍、自闭症谱系障碍)和语言障碍、脑震荡和精神科诊断的儿童进行了基于视频的 TeleNP 筛查。在 65.6%的儿童中发现了其他合并症。大约 2 个月后的随访数据显示,由于基于视频的 TeleNP 评估,98.5%的儿童正在接受新的干预措施。

结论

基于视频的 TeleNP 使消费者受益,因为它可以减少等待时间,减轻家庭经济负担(即旅行和父母请假),加快干预措施的转介,并为地理上服务不足的人群提供能够满足语言和文化需求的提供者。对于提供者来说,这种模式显示出了改进,这直接影响到成本节约,从而促进了私人诊所医疗市场的长期经济可持续性。

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