Pj Juneja, Am Tolczyk, Re Strowd, Ld Strauss, R Graham, L Burton, C Michael, M Ezzeddine, Ep Pharr, J Boggs, S Kumar, C O'Donovan, Ct Tegeler, Guzik Amy K
Department of Neurology, Columbia University, New York, NY, USA.
Department of Neurology, Wake Forest University School of Medicine, Winston Salem, NC, USA.
Neurohospitalist. 2022 Jul;12(3):476-483. doi: 10.1177/19418744221100364. Epub 2022 May 12.
Describe an inpatient teleneurology consultation service novel to our hospital system, and capture feedback from patients, ordering providers, and consulting neurologists. A single cohort of teleneurology consult patients was surveyed via telephone. Ordering and consulting providers completed online surveys. Quantitative survey data was reported using descriptive statistics and free-response survey data was summarized. Patient demographics and consult data were gathered via retrospective chart review. Telephone survey was obtained from 25 of 53 patients receiving teleneurology consults from June 1-September 30, 2020. Patient-reported benefits included better understanding of condition (72%) and ability to remain close to home. Online surveys were completed by 11 ordering providers and by consulting neurologists on 20 telemedicine encounters. Ordering providers reported they were likely to use the service again (98.7%), agreed it added value to patient care (91%) and was valued by patients (82%), with concern for missed diagnosis (46%) and potential patient transfer (36%) without the service. In contrast, fewer consulting neurologists predicted need for transfer (5%) or missed diagnosis (10%) in the absence of teleneurology, though 20% indicated that length of stay may increase without the service. We confirm feasibility of an inpatient teleneurology service run by an academic medical center. Satisfaction was high among all key stakeholders, with few transfers to a tertiary care center. This service is valuable to patients, ordering providers, and potentially the hospital network, as a community based care model of neurological care, centered on the needs of the patient and hospitalist.
描述我院系统中一项新型的住院远程神经科会诊服务,并收集患者、开单医生和会诊神经科医生的反馈。通过电话对一组远程神经科会诊患者进行了调查。开单医生和会诊医生完成了在线调查。定量调查数据采用描述性统计报告,自由回答式调查数据进行了总结。通过回顾性病历审查收集患者人口统计学和会诊数据。对2020年6月1日至9月30日接受远程神经科会诊的53名患者中的25名进行了电话调查。患者报告的益处包括对病情有更好的了解(72%)以及能够离家较近。11名开单医生和会诊神经科医生就20次远程医疗会诊完成了在线调查。开单医生报告称他们很可能会再次使用该服务(98.7%),认为该服务为患者护理增加了价值(91%)且受到患者重视(82%),同时担心没有该服务会漏诊(46%)和患者可能需要转院(36%)。相比之下,较少会诊神经科医生预计在没有远程神经科服务的情况下需要转院(5%)或漏诊(10%),不过20%的医生表示没有该服务住院时间可能会增加。我们证实了学术医疗中心运营住院远程神经科服务的可行性。所有关键利益相关者的满意度都很高,转往三级护理中心的情况很少。作为一种以患者和住院医生需求为中心的基于社区的神经科护理模式,该服务对患者、开单医生以及可能对医院网络都很有价值。