How, when, and for whom: decisions regarding remote neuropsychological assessment during the 2020 COVID-19 pandemic

Ayala Bloch,Gitit Kavé,Sari Maril

doi:10.1186/s13584-021-00465-x

Abstract

Neuropsychological assessment provides crucial information about cognitive, behavioral, and socioemotional functioning in medical, educational, legal, and social contexts. During the 2020 COVID-19 pandemic, the Israeli Ministry of Health initially mandated that all psychological assessments be postponed. However, as referrals to time-sensitive, high-need, and high-stakes assessments began to accumulate, it became necessary to consider remote solutions. In the current paper, we describe the considerations that affected the transition to remote activity in a prominent Israeli provider of neuropsychological assessment and rehabilitation services, referring to technological and environmental conditions, cognitive requirements, and tasks, as well as to legal, regulatory, and funding issues. After discussing how assessments should be conducted to maximize feasibility and validity while minimizing risks to clients and clinicians, we propose a preliminary model for deciding whether specific referrals warrant remote administration. The model delineates key factors in decisions regarding remote assessment, emphasizing the distinct roles of the referring clinician and the neuropsychologist who conducts the assessment, and highlighting the need for collaboration between them. The abrupt need for remote assessments during the pandemic required a quick response with little preparation. The lessons learned from this process can be applied in the future, so that the need for remote services can be met with greater certainty and uniformity.

Highlights

Background and aimsOver a year into the 2020 COVID-19 pandemic, decisions about the provision of remote health services are still largely in the hands of individual clinicians and medical service providers
This model posits that the decision to assess a client remotely should be based on the interplay between five factors: (1) necessity of assessment; (2) urgency of referral question; (3) feasibility, in terms of technological limits or clinical contraindications that might preclude remote assessment; (4) confidence level, or the extent to which the neuropsychologist is confident that the assessment will provide accurate information under remote administration conditions; and (5) required resources and costs associated with remote assessment
Conclusions and implications for policy This paper presents the considerations found relevant by a prominent Israeli provider of neuropsychological assessment services following a rapid and unprecedented transition to remote activity in response to the COVID19 pandemic

Summary

Introduction

Background and aimsOver a year into the 2020 COVID-19 pandemic, decisions about the provision of remote health services are still largely in the hands of individual clinicians and medical service providers. Case illustration: response of an Israeli assessment and rehabilitation organization The considerations and decisions associated with remote assessment during the COVID-19 pandemic are well-illustrated by the response of the National Institute of Neuropsychological Rehabilitation (the Institute; a public non-profit organization), Israel’s largest provider of community-based neuropsychological rehabilitation services for individuals with acquired brain damage.

Results

Conclusion