Reader response: Telemedicine in neurology: Telemedicine Work Group of the American Academy of Neurology update.

Abstract

We read with interest the review of teleneurology by Hatcher-Martin et al.1 There have been limited studies about the use of teleneuroimmunology for antibody-mediated encephalitis.2 We provide some remote teleneuroimmunology experiences of KingMed Diagnostics (KMD), the largest independent medical laboratory in China.3 To date, the number of identified positive neuronal antibodies reached more than 4,500 by 2019 in KMD. One of the most important aspects of teleneuroimmunology in KMD is the close collaboration with consultant neuroimmunologists due to the potential increasing antibody-mediated encephalitis diagnostics service needs, particularly in low-resource areas with a shortage of specialists.4 Teleneuroimmunology focuses on counseling—i.e., providing second opinions on challenging cases—education, and reviewing diagnostic test results, conducting over 100 consultations each year. Teleneuroimmunology also seems to improve satisfaction between distant neurologists and the referral site, although quality control programs are limited. Potential challenges include lack of qualified physical examination and legal concerns. Together, our experiences may help in showing unique solutions in improving the diagnosis of rare diseases practice in China as well as in other developing countries.