Neurology accounts for 8-10% of hospital admissions including patients with strokes, epilepsy, cognitive and neuromuscular disorders.
While the demand for neurology services is rising, the supply isn’t keeping up, leaving overworked neurologists feeling burned out and depressed.
Healthcare providers — including academic and community hospitals, rural facilities, ASCs and outpatient clinics — are adding to or supplementing their local neurology resources by partnering with teleneurology programs.
To explore how teleneurology helps enhance providers’ neurology services, Becker’s Healthcare spoke with Annie Tsui, DO, chief medical officer of neurology at Access TeleCare.
Note: Responses have been edited for length and clarity.
Becker’s: What types of neurology programs does Access TeleCare provide?
Dr. Annie Tsui: Access TeleCare partners with healthcare organizations to provide comprehensive neurology services from the moment a patient comes through an ED door until they are discharged, and beyond.
This includes acute neurology services, which are both emergent and non-emergent in nature. Emergent services can include acute stroke care, while non-emergent can involve follow-up rounding and routine daily consults.
Access TeleCare also provides ambulatory neurology services, such as a general neurology clinic to manage chronic conditions, as well as, a post-discharge clinic to support shorter length of stays and value-based care models.
Lastly, Access TeleCare’s neurology services includes electroencephalogram (EEG) readership for all types of EEGs — including “spot” and continuous EEGs — across the entire age spectrum.
Q: What types of healthcare organizations look to partner for teleneurology services?
AT: Due to national neurologist shortages, many healthcare organizations lack the neurology resources and expertise they need to support their community. Some organizations lack any neurologists, while at other facilities, neurologists are spread thin. This includes the spectrum of academic medical centers, , community hospitals, rural facilities. Partnering to have expert neurologists available at all times via telemedicine is a bridge to address gaps in neurology care.
Q: What are outcomes and benefits of teleneurology for patients and providers?
AT: For patients, teleneurology provides fast access to expert neurologists, while in their local care networks. It improves their care and health outcomes while also providing a convenient, satisfying experience.
For providers, having neurology expertise available via telemedicine relieves pressure. The primary care team is able to maintain care of the patient without having to transfer them to another care setting, by gaining access to a neurology expert that co-manages that patient alongside them. Additional neurology support also reduces the burden on and burnout of current neurologists.
A case study also found that six Tennessee hospitals with teleneurohospitalists reduced transfers of neurology patients by 60% while increasing neurology inpatient revenue by 80%.
Q: How has Access TeleCare partnered with providers to move the needle on stroke performance measures?
AT: Every year about 800,000 people in the United States have a stroke, making stroke care a major point of focus for hospitals. A key metric for providers is door-to-needle (DTN) time, since every minute of delay in treatment after a stroke can lead to worse outcome.
Access TeleCare’s neurologists are immediately available for consultation when alerted by a provider partner about a potential stroke. However, Access TeleCare’s impact in helping partners improve outcomes goes beyond the immediate patient evaluation.
Working in collaboration with partners, Access TeleCare forms DTN task forces involving medical directors and other key care champions. These task forces map every detail of the DTN timeline and find ways to improve the speed and performance in responding to strokes.
As a result of these collaborative programs, Access TeleCare and several of their partner facilities — including Hendrick Health (West Central Texas), Methodist Mansfield Medical Center (Texas) and others — have decreased their DTN time by 30% or more.
Through collaboration and emphasis on clinical protocols, processes and workflows, Access TeleCare has also helped facilities achieve and maintain stroke designation certification. Access TeleCare can serve in a consultancy capacity to create new stroke program plans. Access TeleCare can also bolster existing stroke programs by providing stroke medical director leadership.
Q: Beyond clinical outcomes, how do teleneurology programs create operational and financial value for hospital partners?
AT: By having virtual access to neurologists in their local care communities, hospitals can decrease their outbound transfer of patients, which can save thousands of dollars per avoided transfer.
Access TeleCare’s neurology team also recognizes High Reliability Organizational principles and provides support to improve quality of care and decrease costs through continuous process improvement efforts that reduce waste and variation.
The bottom line is that amid today’s neurologist shortage, where many facilities lack adequate neurology coverage and onsite neurologists are spread thin, partnering with high-quality teleneurology services expands access to expertise, improves patient outcomes and grows revenue while easing the burden on staff.
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