Telemedicine is no longer just a pandemic aid

The COVID-19 pandemic gave us our best look yet of the power of telemedicine. At a time when access to hospitals was limited, the remote model of diagnosis and treatment came to the rescue of several people. What is interesting is that this helped not only with the common flu, COVID-19, and mental health therapy, but also with neurological diagnosis and treatment.

Researchers at the Division of Neurology at the Children’s Hospital of Philadelphia (CHOP) have shown in a study the efficacy and acceptance of a remote model for paediatric neurology. The study establishes the advantage of the convenience telemedicine offers over traditional methods of care.

The study included 14,780 in-person and 2,589 telehealth consultations, between 1 October 2019 and 24 April, 2020. The researchers found that 93 per cent of the teleconsultation visits (1,200 out of 1,286) had a satisfactory outcome and 89 per cent suggested telemedicine as a potential option for follow-up care.

The researchers further found that though a few technical challenges popped up in running the telemedicine for paediatric neurology programme, 86 per cent of individuals and caregivers showed acceptance of telemedicine for future care.

A smart system

The programme coordinators instructed the individuals or their caregivers to download a ‘patient portal’ application onto their smart phones. Appointments were booked through the application, which is integrated with electronic medical records (EMR) data.

One day before the consultation, nursing assistants called the individuals to guide them through the process and give additional instructions that helped in improving the likelihood of successfully accessing the portal. Healthcare providers documented the telemedicine programme data within the EMR using templates that included the important medical history of the individuals.

“Our findings demonstrate how telemedicine has become a standard component of child neurology care for many patients,” says Ingo Helbig, MD, a paediatric neurologist at CHOP, director of the genomic and data science core of CHOP’s Epilepsy Neurogenetics Initiative (ENGIN) and senior author of this study.

The Covid push

“In 2020, the COVID-19 pandemic necessitated the use of telemedicine visits, but now that telemedicine visits have been established as part of the care we are able to deliver, we had the opportunity to compare them more thoroughly to in-person visits,” said the study’s first author Michael Kaufman, a data scientist with the Epilepsy Neurogenetics Initiative (ENGIN) at CHOP, in a statement.

The researchers suggested that most of the child neurology care may be delivered effectively via remote history gathering and virtual examinations. In some cases, telemedicine might be able to eliminate care-related obstacles brought on by in-person interactions. This service could be particularly advantageous for underserved individuals whose carers cannot afford to miss work. It could also help those who reside far away from hospitals, or who have unique transportation requirements.

The study’s findings showed that telemedicine was a practical choice for a lot of individuals. It also showed that it was used more frequently than in-person consultations for some individuals, such as those with epilepsy and attention-deficit hyperactivity disorder.

However, for those diagnosed with neuromuscular and mobility diseases, younger individuals, and those in need of special procedures, at least one in-person consultation was essential.

Dr Sujith Ovallath, head of Neurology at Baby Memorial Hospital in Kannur, tells Happiest Health, that there can be challenges. He explains, “Most neurological disorders are diagnosed using pattern identification. Under such conditions, conducting in-person consultations, followed by teleconsultations would reduce the burden on caregivers and doctors alike.”

According to Dr Ovallath, hybrid models that include both in-person and telemedicine can be a game changer for paediatric care in developing countries as well. It could help in providing timely diagnosis and treatment.