Outcomes from a US military neurology and traumatic brain injury telemedicine program

Yurkiewicz, Ilana R.; Lappan, Charles M.; Neely, Edward T.; Hesselbrock, Roger; Girard, Philip; Alphonso, Aimee L.; Tsao, Jack W.

doi:10.1212/wnl.0b013e31826aac33

Cited by 37 publications

(25 citation statements)

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“…Nonetheless, with a more streamlined process, the overall response time can be shortened to approximately 8 h, according to the military telemedicine program. 41 One solution calls for the hospitals to establish a green channel, especially for cases that present from the emergency room and the ICU. Despite the difficulty of cross-origin resource sharing in China hampering the implementation of a synchronous desk-to-desk consultation, which establishes real-time communication, data transfer between primary doctors and specialists directly is needed.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Utilization and Cost-Effectiveness of Telemedicine Program in Western Regions of China: A 12-Year Study of 249 Hospitals Across 112 Cities

Wang

Zhu

et al. 2016

Telemedicine and e-Health

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Section: Discussionmentioning

confidence: 99%

Assessment of Utilization and Cost-Effectiveness of Telemedicine Program in Western Regions of China: A 12-Year Study of 249 Hospitals Across 112 Cities

Wang

Zhu

et al. 2016

Telemedicine and e-Health

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“…Acute stroke care has benefited the most so far from the advent of this technology [1][2][3][4], but other neurological applications have been reported [5][6][7][8]. Telemedicine has the potential of improving access of patients with epilepsy residing in rural areas to epileptologists in tertiary care centers [9,10].…”

Section: Introductionmentioning

confidence: 99%

Telemedicine for patients with epilepsy: A pilot experience

Haddad¹,

Grant²,

Eswaran³

2015

Epilepsy & Behavior

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“…8 A body of evidence now exists that telerehabilitiation is potentially effective at directing functional recovery in patients with TBI. 9 Videoconference-based telemedical neuropsychological assessments have been shown to be as accurate as face-to-face interactions.…”

Section: Resultsmentioning

confidence: 99%

Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion

et al. 2017

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Objective: To assess the feasibility and accuracy of telemedical concussion evaluations (teleconcussion) for real-time athletic sideline assessment of concussion, as such assessment may address the gap in access some populations of athletes have to providers with expertise in concussion evaluation.Methods: A cohort of 11 consecutive male collegiate football players with suspected concussion was assessed using Standardized Assessment of Concussion (SAC), King-Devick test (K-D), and modified Balance Error Scoring System (mBESS). A remote neurologist assessed each athlete using a telemedicine robot with real-time, 2-way audiovisual capabilities, while a sideline provider performed a simultaneous face-to-face assessment. After the assessment, a remove-from-play (RFP) determination was made. The remote and the face-to-face providers were blinded to each other's examination findings and RFP decision until the end of the assessment. Results:The teleconcussion and face-to-face SAC were in agreement 100% of the time (6/6; 95% confidence interval [CI] 54%-100%). The mean (SD) difference between remote and sideline K-D times was 0.7 (1.4) seconds. Remote and sideline K-D times were within a 3-second difference 100% of the time (11/11; 95% CI 72%-100%). Remote and sideline mBESS scores were within 3 points 100% of the time (6/6; 95% CI 54%-100%). RFP decisions were in agreement 100% of the time (11/11; 95% CI 72%-100%). Conclusions:The aim of this study was to investigate the feasibility of teleconcussion for sideline concussion assessments. These data suggest a high level of agreement between remote and face-to-face providers with regard to examination findings and RFP determinations. An estimated 1.6-3.8 million traumatic brain injuries (TBIs) occur annually in the United States among 38 million children and adolescents and 170 million adults engaged in organized physical and sports-related activities.1 To help improve concussion and TBI identification and postinjury care, some sports organizations have employed unaffiliated neurotrauma consultants to provide sideline evaluation for suspected injuries. This same level of care is not available for most youth and collegiate-level athletes. Of more than 4,000 US colleges and universities, 3 most have qualified medical staff providing care for elite-level sports teams; however, most have no access to neurotrauma experts on the sideline. Moreover, among the 37,000 US public and private secondary schools, 4 58% do not have access to any sideline medical personnel (including athletic trainers).5 This problem may be compounded by geographic disparities as rural colleges, universities, and high schools may have even less access to specialty care than schools in major metropolitan areas.Telemedicine has been shown to be a safe and effective means to evaluate and treat numerous acute neurologic conditions, including stroke, 6 in populations with limited access to subspecialty care.

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Outcomes from a US military neurology and traumatic brain injury telemedicine program

Cited by 37 publications

References 0 publications

Assessment of Utilization and Cost-Effectiveness of Telemedicine Program in Western Regions of China: A 12-Year Study of 249 Hospitals Across 112 Cities

Assessment of Utilization and Cost-Effectiveness of Telemedicine Program in Western Regions of China: A 12-Year Study of 249 Hospitals Across 112 Cities

Telemedicine for patients with epilepsy: A pilot experience

Feasibility and accuracy of teleconcussion for acute evaluation of suspected concussion

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