Making the Case for Telemedicine

By: Andr??a Stanford

Today neurologists are faced with two key challenges: an increasing shortage of cognitive care specialists and an aging population riddled with neurologic conditions, such as stroke and dementia.  As a result, patients with limited access to neurologic expertise, including those living in rural or geographically underserved areas, individuals with limited mobility, and those deployed in the military, have felt the brunt of these obstacles.

One growing solution to these problems is “teleneurology,” or the practice of using audio-visual conferencing to administer neurological bedside care. According to a recent report of the Telemedicine Work Group of the American Academy of Neurology, published in the Neurology journal, teleneurology has proven to be highly effective in improving care and increasing access for patients.   
“Teleneurology is an exciting and growing field. It allows a neurologist to be at the bedside virtually almost anywhere in the world in real-time,” explains Lawrence R. Wechsler, M.D., lead author of the report and professor and chair of the Department of Neurology at Pitt’s School of Medicine, and vice president, telemedicine, for  UPMC’s Physician Services Division. “This is a means of delivering expert care to patients where they otherwise might not be able to get this level of care.”
Lawrence R. Wechsler, M.D. 
For ailments such as stroke that require rapid assessment or for patients with Parkinson’s disease who suffer from impaired mobility, telemedicine is critical. This technology isn’t just reserved for clinical practice for civilians; the Department of Veterans Affairs has also integrated telemedicine services into the treatment and management of traumatic brain and spinal cord injuries for active military personnel.
Additionally, telemedicine sharpens the network of collaboration among neurologists, primary care physicians and other healthcare professionals.  Hub-and-spoke models, which align primary stroke centers (hubs) with smaller, regional rural or underserved facilities (spokes), enable an exchange of information and education, Dr. Weschler explains.
“It’s a way for practitioners to expand their horizons, improve the care they deliver to their patients and improve their practice in many ways that are limited only by our imagination.”
While highlighting the advantages of this technology, the article also outlines some of the hurdles, including:
  • Concerns that this communication will disrupt existing doctor-patient relationships.
  • Physician reluctance to implement new technology in routine practice.
  • Difficulties in performing a complete neurologic exam via telehealth.
To hear more of Dr. Wechsler’s thoughts on this growing area of medicine, visit to listen to his podcast interview.