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Teleneurology: Closing the Gap for Transformative and Inclusive Neurologic Care
“It's not a faith in technology. It's faith in people.” Steve Jobs
Teleneurology is the delivery of neurologic care through the exchange of healthcare information across distances; it is not a technology, device, or a separate and new branch of neurology. The interest and reach of teleneurology increased exponentially as the COVID-19 pandemic posed an extraordinary challenge to health delivery systems everywhere. While in the past, rural and sparsely populated areas benefitted from telestroke as the vital and life-saving link to appropriate neurology care, currently the benefits (and challenges) of teleneurology span all subspecialties of neurology everywhere. When appropriately indicated and performed, teleneurology care provides a safe, timely, efficient, effective, equitable, and patient-centered alternative to clinic- or hospital-based care.
This issue of Seminars in Neurology is devoted to a review of best practices and outcomes of the many faces of teleneurology. The review manuscripts range from detailed descriptions of well-established (e.g., telestroke) as well as emerging (e.g., teleneurohospitalist, teleneuroICU, teleEEG) service lines to the use of novel technologies (artificial intelligence, digital phenotyping) and key considerations surrounding teleneurology utilization (ethics, diversity and). This issue begins with Drs. Turner and Etherton's concise and up-to-date summary of over two decades of research and clinical experience on the utilization of telestroke care to manage patients arriving to hospitals within tissue plasminogen activator and intra-arterial treatment windows. The next article, by Drs. Matiello and Cohen, offers a far-reaching review of the current and cutting-edge aspects of teleconsultative services for hospitalized patients with all manner of neurological diseases (teleneurohospitalist). In the following article, Drs. Rabinstein and Freeman discuss the experience and evidence of providing neurocritical care consultations and expertise through telehealth. In the next article, Drs. Murphey and Anderson review the current concepts and processes for EEG remote evaluation, including a special section related to pediatric populations.
The next two articles address the potential for technological breakthroughs for neurologic care with the use of artificial intelligence algorithms (Drs. Hillis and Bizzo) and the precision and promise of digital phenotyping of neurologic diseases (Dr. Gupta). Finally, two articles discuss important themes related to teleneurology. Drs. Saadi, Mendizabal and Mejia review the data on teleneurology as a mechanism to improve the care of underserved populations. Dr. Young reviews important ethical concepts involved in the use of teleneurology.
We would like to offer our deepest appreciation to Drs. Greer and Lewis, editors of Seminars in Neurology, for their great attention to critical details in each step of planning and editing this issue, and for their vision in offering the Seminars in Neurology readership the important and cutting-edge concepts around teleneurology. The past year has seen greater change and adoption of telehealth than the 20 years that preceded it, and the future is bright for further digital transformation of neurological care.
Article published online:
16 May 2022
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