Existing literature suggests that use of telemedicine during postoperative appointments can increase access to care and is valued by patients and providers alike. While research examining the clinical equivalency of telemedicine visits for postoperative care has been growing, few studies have reported on telemedicine follow-up after neurosurgery. This study examined if a videoconferencing visit could substitute for an in-person clinic visit for elective neurosurgical cases in the USA. This was a single-center prospective study of patients who underwent elective neurosurgical procedures (aneurysm clipping, resection of cavernous angiomas, resection of arterial venous malformation, microvascular decompression for trigeminal neuralgia and hemifacial spasm, and certain benign brain tumors) and were offered telemedicine follow-up care by an allied health professional during the first 90 days after neurosurgery. Prospective data was compared to a historical group of patients who underwent the same procedures and received in-person postoperative follow-up. Patients in the prospective group were contacted by telephone 2-6 weeks after surgery by a nurse practitioner and assessed using a standard template that included incidence of reported postoperative seizures, fever, and performance of activities of daily living. Primary outcome measures included percentage of patients accepting telemedicine, clinical and functional status, complications, patient satisfaction, patient travel time and distance, and rates of emergency room care or hospitalization within 90 days of discharge. Ninety-nine patients were included in the study, with 57 in the prospective group and 42 in the historical group. Of the 57 prospective patients, 47 accepted telemedicine in lieu of an in-person clinic visit. Emergency room visits and readmission rates at 30 and 90 days postoperatively did not differ significantly between the study groups, nor was there any significant difference in clinical variables that were recorded in the electronic medical record more than 80% of the time. This study demonstrates the safety and value of telemedicine as an alternative method of postoperative clinical care for patients undergoing elective neurosurgery. Telemedicine avoids unnecessary travel time and was welcomed by the majority of patients without compromising clinical or functional outcomes.

Background: Telemedicine enables providers to connect with patients and consultants remotely in a cost-effective, convenient manner. Telemedicine in various forms-from store-and-forward technology to real-time videoconferencing-has demonstrated good outcomes in specialties including neurosurgery, general neurology, stroke, and epilepsy. Aim: To demonstrate the feasibility of telemedicine in an outpatient university-based neurology clinic, and assess patient and provider satisfaction with telemedicine. Methods: Forty neurologically stable adult patients were recruited. We excluded patients who were non-English speaking, had intellectual disability, lacked caregiver availability, or had unstable neurological conditions. After each telemedicine visit a patient standardized satisfaction survey was completed, comprising 11 questions assessing patient willingness to participate, technical issues, and satisfaction with the clinic experience and medical provider. A provider satisfaction survey was obtained at the end of the study. Results: Forty of fifty patients meeting criteria consented to a telemedicine visit in lieu of a routine visit, and 15 of these responded to survey. All felt confident when meeting with their provider met their needs. Ninety percent of participants agreed that the technical process of joining the on-line session was easy. All patients agreed that they were satisfied with their telemedicine session and would choose telemedicine over face-to-face visits in the future. Cost analysis demonstrated a UCLA healthcare system saving of $28.00 for each telemedicine replacing an in-person clinic visit. Patients saved the cost of auto fuel, missed work, and parking when using the telemedicine option. Conclusions: Telemedicine in neurology patients is feasible and satisfies patients and providers.

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