Neurologists' perceptions of utilising tele-neurology to practice remotely during the COVID-19 pandemic. Issue 3 (March 2021)

• Record Type: Journal Article
• Authors: Courtney, Ellie; Blackburn, Daniel; Reuber, Markus
• Is Part Of: Patient education and counseling. Volume 104:Issue 3(2021)
• Page Start: 452
• Page End: 459
• Publication Date: 2021-03
• Subjects: Tele-neurology -- Telemedicine -- COVID-19 -- Remote -- Telephone -- Videophone; Patient education -- Periodicals; Health counseling -- Periodicals; Health education -- Periodicals; Counseling -- Periodicals; Patient Education -- Periodicals; Éducation des patients -- Périodiques; Counseling -- Périodiques; Éducation sanitaire -- Périodiques; 615.5071
• DOI: 10.1016/j.pec.2020.12.027
• Languages: English
• ISSNs: 0738-3991

Abstract

Highlights: Lack of non-verbal communication and examination are associated with risks. Tele-neurology is limited in neuromuscular, functional and cognitive patients. Remote consultations are suitable for on-going long term follow up patients. Considerable administrative and infrastructural investments are required. Clinicians found their jobs less rewarding whilst practising remotely. Abstract: Objectives: The COVID-19 pandemic enforced an almost complete switch from face-to-face clinical work to tele-neurology. This study explores neurologists' perceptions of telephone and videophone remote consultations. Methods: Semi-structured interviews were conducted with neurologists and a GP with a specialist interest (n = 22). Interviews were conducted remotely via Zoom®, audio-recorded, transcribed verbatim and analysed using the principles of thematic analysis. Results: Four main themes emerged: 'unknown unknowns (risks/uncertainties)', 'better service', 'challenges', and 'beyond the pandemic'. Thematic saturation was achieved by interview 19. Participants highlighted a number of benefits of remote consultations but over 80% also complained of a reduction in work satisfaction. Conclusion: The sudden introduction of tele-neurology is unlikely to be fully reversed when pandemic-related restrictions have been lifted. However, this study confirms tele-neurology cannot completely replace face-to-face consultations. Some patient groups and consultation types require direct contact. Moreover, significant administrative and infrastructural investment will be required to develop the full potential of tele-neurology. Practice implications: Tele-medicine is capable of improving access and efficiency of specialist neurology services, but limited by lack of non-verbal communication and technical problems. It could enhance service provision with sufficient infrastructural and administrative investment, but may reduce neurologists' job statisfaction.