Using Teleneurology to Deliver Chronic Neurologic Care to Rural Veterans: Analysis of the First 1,100 Patient Visits.

Abstract

A challenge confronting the United States is delivery of quality specialty healthcare to citizens living in rural areas. The Veterans Administration (VA) developed a large national telehealth network to address 5.2 million rural veterans. New Mexico's Albuquerque VA Neurology Service developed a teleneurology program for their rural veterans. This article analyzes our first 1,100 teleneurology patient visits. Veterans living in remote areas of New Mexico, southern Colorado, eastern Arizona, and western Texas were offered follow-up teleneurology care at 16 rural VA community-based outpatient clinics (CBOCs) following an initial evaluation at the Albuquerque VA neurology outpatient clinic. Surveys were sent after all teleneurology visits focused on quality of care, ease of communication, satisfaction, and staff's ability to deliver same quality care as in person. Problems encountered, differences between face-to-face clinics and teleneurology, and cost savings were examined. Regarding the 701 (64%) returned surveys, we found 90% perceived they received good care, 91% felt there was good communication, 88% liked the convenience, and 87% reported they desired to continue teleneurology care. Ninety-six percent reported saving time, money, or both through CBOC visits instead of driving to Albuquerque. All providers felt that they could deliver excellent care through teleneurology. We found emergency room visits for neurologic problems was similar for both groups. Our rural veteran patients and neurology staff overwhelmingly found high quality patient care can be delivered via teleneurology for a variety of chronic neurologic problems and was comparable to care delivered in neurology face-to-face clinics.