Clinical Telemedicine Blog

SOC Teleneurology Team Thanks EMS Personnel

By Amy Levitt

Medical equipment on isolated black background, horizontal.jpeg

It’s National EMS Week and Specialists On Call would like to take this opportunity to thank all Emergency Medical Services personnel for their vital public service and positive impact they have on the survival of anyone who experiences sudden injury or illness. We’d like to especially say thank you for their contributions to early recognition of stroke. For more than half of all stroke patients EMS is the first medical contact they have. These patients are dependent upon EMS personnel’s ability to accurately and quickly recognize the signs of stroke and get them to a neurology specialist who can prescribe life-saving treatment.

Due to the short eligibility window for administering tPA, EMS responders and SOC’s TeleNeurology service are essential to the quality of stroke care.  Since there’s almost no way for EMS personnel to know precisely when the symptoms started, it’s even more critical that they transport the patient to a hospital that can guarantee a neurologist available for consult. Specialists On Call is the largest provider of teleneurology care in the world, with over 4,000 patients treated every month and more than 200,000 consultations performed to date. In many instances, even with a 15 minute response time, we still wouldn’t have had the opportunity to see and save a patient were it not for the expertise and fast thinking of the EMS responder.

To all Emergency Medical Services personnel: thank you. We recognize and honor you during National EMS week as well as the remaining 51 weeks a year.  We look forward to continuing our collaboration in improving stroke care.

Contact us to learn more about how we can help improve stroke care in your hospital.

Topics: telemedicine, Stroke, neurology, teleneurology, emergency neurology, stroke awareness, Emergency Medicine, Neurologic Emergency, Neurologic Emergencies, SOC, emergency departments

Telepsychiatry, The Right Time But Not Yet In Enough Places

By Chris Pick

This week I was reading a January 2012 TRENDWATCH from the American Hospital Association entitled “Bringing Behavioral Health into the Care Continuum:  Opportunities to Improve, Costs and Outcomes.”  While I work with and around the problem every day it makes me pause whenever I see some of the numbers. 

….among children mental health conditions were the 4th most common reason for admission.

….27% of Americans will suffer from a substance abuse disorder in their lifetime.

….in 2009, more than 2 million discharges from community hospitals had a primary mental health diagnosis

….in the past year, 34 million adults had comorbid mental health and medical conditions

Here is what it means:

Patients with comorbid mental health and medical conditions experience higher healthcare costs, with much of it attributable to higher medical, not mental health, expenditures. Individuals with comorbid conditions are at a heightened risk of returning to the hospital after discharge. 

There is a critical shortage of behavioral healthcare treatment capacity. According to the report, 55% of US counties have no practicing psychiatrists, psychologists, or social workers. Only 27% of community hospitals have an organized inpatient psychiatric unit, while state and county hospitals are closing to financial constraints.  Emergency department visits and resulting problems like boarding are on the rise.

With health care parity for mental health, healthcare technology advances, and public and government pressure to reform and recreate healthcare delivery, telepsychiatry is quickly becoming a solution. It allows the too small pool of psychiatrists, who are not evenly geographicly distributed, to meet the growing national mental health challenges.  We see the armed forces, the Veterans Administration, rural counties, managed care and many entities using telepsychiatry to reach no, low or special needs access areas.  Specialists in substance abuse, child psychiatry, mental retardation, and geriatrics can reach dispersed patient populations in need of a higher level of specialization. 

Increasingly we are seeing hospitals, who previously did not have or could not maintain sufficient on demand coverage,  identify and take advantage of the improved quality, cost, and outcomes that telepsychiatry offers.  The new questions become:

-What is the benefit to the care of the co-morbid patient when the hospitalist has a Psychiatrist to consult? 

-What is the benefit to the hospital that has no mental health services but has patients whose primary diagnosis is a mental health condition being brought to the Emergency Department and admitted to the hospital?

-What is the benefit of being able to diagnose, stabilize, manage, and direct to appropriate treatment the patient who is undiagnosed, untreated, or suffering from exacerbated mental health symptoms?

-What is the benefit when a child, elderly person, substance abuser comes to the hospital with an acute mental health problem and a specialist in that field is there to help?

-What is the savings when a psychiatrist is almost instantly available to determine capacity, treat emergent and urgent cases, and provide specialized recommendations?

Increasingly, as telepsychiatry is being used in the hospital setting, outcome studies all show that with early intervention, assessment, and treatment there is reduced cost of care, LOS, readmissions, staff burden and risk; and there is increased quality, services, and satisfaction. 

My work deals with the problems of how to address the mental health challenges that our hospitals and their communities are facing. Every day I show hospitals that telepsychiatry is a tool to decompress ED’s, provide needed specialty treatment, and reduce the costs hospitals bear while trying to meet the needs of the people they serve.  Can we afford not to address this growing problem?  There is still a ways to go in improving the national landscape for telepsychiatry (new prescribing laws and national licensing, reimbursement and medicare coverage, and so on…), but in your community the answer may already be here.

Topics: telemedicine, healthcare, Emergency Medicine, Physicians, telemedicine solutions, Specialists On Call, SOC, hospitals, telepsychiatry, emergency departments, emergency department, On Call Coverage, Telepresence, Specialty Physician Shortage, Patients, Emergency Psychiatry, telehealth, psychiatry

Teleneurology Provides Rapid Response from a Top Level Neurologist

By Jeff Simer

Two weeks ago I had the pleasure of attending the Society of Interventional Radiologist CLOTS training course in Dallas TX. The course is staged as a comprehensive five-day training course is composed of in-depth multidisciplinary lectures emphasizing the entire spectrum of stroke diagnosis and management.

The conference was centered around the minimally invasive approach to advanced ischemic stroke intervention and all of the management considerations, along with this, there was a full suite training course on the various techniques and medical device technology-from imaging to the catheter based solutions to intervention.

There were many presentations at the meeting, presenting many findings from some of the luminary interventional programs in the U.S. and Europe. 

Several presentations focused specifically on the overall process in which acute ischemic stroke is identified, triaged, processed, and managed on a systemic level.  This approach is generally considered a “Hub and Spoke” a model of developing a transfer pattern with in a defined geography where institutions that do not have in-house interventional capabilities can efficiently refer the appropriate cases to the “hub” for the advanced procedure that would not be able to be performed in-house at the originating site.  This model is particularly attractive to the interventional team as the number of in-house cases that present are generally not in sufficient numbers to fully support and justify the cost burden of a full swing interventional program. 

SOC attended this course in order to bring attention to one of the key issues that hinders these programs from realizing their growth potential-Acute Emergency Neurological consultation in the ED.  All interventional programs depend on the neurology staff of any given institution to identify candidates for both IV lytics, medical management, and in most cases, those that would benefit from advanced intervention in a bi-plane suite.  Many community level hospitals do not have 24/7/365 neurology to cover ED stroke call.  Even those that do, do not have the ability to respond to stroke codes within the “window” that stroke cases require to capture the opportunity for either lytics administration or intervention.  Hence the emphasis on how to create a network of hospitals that can feed an interventional practice.  This window is often lost due to the response times from the local specialists.  The lytics window is up to 4.5 hours for IV, and 8-12 for endovascular therapy.  The SOC specialists are guaranteed to respond in 15 minutes or less, thereby shortening the time that is lost waiting for a specialist to give an opinion on the case. 

Many Interventional programs lack the depth of call and expertise to provide such rapid response to neurological emergencies in the community setting.  With that said, many of the institutions that develop partnerships as “hub and spoke” lose momentum as the neurological consulting staff is not deep enough to provide 24/7/365 call coverage in a consistent and rapid fashion-burn out ensues and the network loses its effectiveness.  As a result, many of the partners lose confidence in calling for consultation and revert back to just sending all cases to the tertiary center.  This is neither good for the patient nor the receiving hospital, as the vast majority of cases are ones that can stay at the originating hospital and need not be transferred away from the community.  The receiving hospital is then using resources to manage patients that could have been kept at the partner site and not using the resources for advanced care. 

SOC had Dr. Heather Linn present on the history of SOC, the methods and value that having the availability of rapid response from a top level neurologist.  She articulated to the audience how 15 minute response time, along with the correct information has allowed SOC doctors to deliver more front line acute stroke care than any other neurological practice in the U.S.  Because SOC physicians are all fellowship trained and also well versed on the available interventional treatments available in most tertiary centers, SOC is uniquely able to assist both hubs and partner hospitals in tending to the extremely time sensitive nature of acute ischemic and hemorrhagic strokes.  With that said, there was considerable interest from the interventional field in how SOC can partner in assisting the flow and triage of patients that are appropriate candidates for advanced neuroendovascular procedures.  The body of specialists I spoke to were blown away with the volume of cases that the SOC physician staff has responded to, on average over 10,000 a year.  Further, they were also impressed with the ability to appropriately manage and in many cases recommend treatment for these critically ill patients. 

I very much enjoyed the presentations I attended and want to thank everyone that stopped by the booth and asked questions or for more information.  It is clear that there is high value in utilizing the SOC solution as a key component in an advanced neuro-rapid response outreach program.  I look forward to seeing more partnerships with SOC as an integral part of advanced Neuroscience initiatives.

Topics: telemedicine, Stroke, neurology, teleneurology, emergency neurology, healthcare, Emergency Medicine, Neurologic Emergency, Physicians, Neurologic Emergencies, telemedicine solutions, Specialists On Call, SOC, hospitals, emergency departments, emergency department, On Call Coverage, Telepresence, Patients, telehealth, neurologists, telestroke, Efficiency, CLOTS, Society of Interventional Radiologist

World Stroke Day - Learn the Warning Signs of a Stroke

By Joe Peterson, M.D.

Warning signs of stroke1 in 6 men and 1 in 5 women will experience a stroke in their lifetime; Every two seconds, someone in the world suffers a stroke; Every six seconds, someone dies of a stroke; Every six seconds, someone’s quality of life will forever be changed – they will permanently be physically disabled due to stroke.

 

Today is World Stroke Day, a day dedicated to promoting stroke awareness.  SOC is proud to be one of the companies helping to fight this epidemic. There are 800,000 strokes a year in the USA; approximately one of every 50 is evaluated by a SOC physician.

In honor of World Stroke Day we want to remind you of the tremendous work we do made possible because of the amazing employees, partners, hospital partners, and physicians we work with. Consider that, with your help, SOC:

  • Provides 24/7/365 on-call emergency teleneurology coverage for 225+ hospitals in 23 states
  • Delivers over 2,000 emergency teleneurology consultations each month
  • Has conducted more than 55,000 emergency teleneurology consultations in less than 6 years – more than any bricks and mortar medical facility in the country
  • Delivered 13,000+ stroke consults per year
  • Oversaw the administration of t-PA 900+ YTD 2012

Knowing the warning signs and getting someone who may be suffering a stroke to the hospital quickly allows them to be assessed for the clot-busting drug t-PA, which may reduce disability or death from stroke. An easy way to recognize the sudden signs of stroke is to remember FAST:

F – Face - can the person smile?
A – Arm - Can the person raise both arms?
S – Speech - Can the person speak clearly and understand what you say?
T – Time - Act FAST!

By simply educating yourselves and your families on the signs and symptoms of stroke and seeking immediate treatment, together we can make a profound improvement in the care of stroke patients across the country!

 

        Joe Peterson, MD

JP Signature

Topics: telemedicine, Stroke, neurology, teleneurology, emergency neurology, stroke awareness, healthcare, Emergency Medicine, Neurologic Emergency, Physicians, Primary Stroke Centers, Neurologic Emergencies, World Stroke Day, telemedicine solutions, warning signs of stroke, FAST test for stroke, Specialists On Call, SOC

Alabama Broadband & Telehealth Summit Recap

By Sam Klement

Last week I had the privilege of attending this 1st annual symposium which had over 225 people in attendance.  To say this inaugural event was a success would be a gross understatement! I personally spoke with folks from as far away as Texas and many other states including Mississippi, Georgia, Louisiana, Kentucky, Florida and more. Dr. Stephen Suggs, Specialists On Call Teleneurologist, presented a very well received session that highlighted 5 Impacts of Telemedicine to Prattville Baptist Hospital (you can get the executive summary here.)

I was also able to attend other sessions including those by Ron Sparks, Senator Taylor, Dr. Carl Taylor, APT COO Dr. Jeffery Kesler, and Executive Director of Connecting Alabama Jessica Dent. There is a lot of commitment to bring the GPT model to Alabama and to get telehealth reimbursed for all payers. The overall messages resonated with SOC’s focus on patient care – connecting patients with the right doctor when they need it.

My goals for attending the conference were to learn everything I could about the APT initiative, hear from thought leaders in Alabama, and meet some of our SOC partners. I also wanted to let the other attendees know that SOC is the leader in telehealth and that we have a local representative. I feel like I accomplished it all!

Thanks to everyone that came by the SOC booth and especially to those that were singing the SOC praises loud and proud! I look forward to attending again next year!

Topics: telemedicine, teleneurology, telepsychiatry, telehealth, Alabama Broadband & Telehealth Summit, GPT

Telemedicine Fosters ACO Readiness

By Amy Levitt

In every service area there are new incentives for large and small hospitals—plus outpatient facilities, home health agencies and community practices—to work in greater harmony than ever before. Some of those incentives are based on the Accountable Care Organization (ACO) paradigm, which is steadily gaining ground as a collaborative, patient-centered standard of care.


The ACO model is intently focused on collaboration to improve patient outcomes, and telemedicine is already playing a key role in the transition. Telemedicine lets large hospitals begin building relationships with smaller hospitals and health organizations in the community, and it can dramatically improve outcomes—from initial diagnosis to long-range results.

Take, for example, the treatment of strokes. Here’s a hypothetical scenario that illustrates how telemedicine can build ACO-style relationships:

A patient goes to the emergency room at Northern Hospital of Surry County or Davis Regional Medical Center in North Carolina suffering stroke-like symptoms. The small community hospital doesn’t have a staff neurologist, but it can rapidly set up a telemedicine consultation with a top neurologist from SOC, obtain expert diagnosis and treat the patient quickly with the clot-busting drug tPA if needed or if necessary, send the patient for a higher level of care and possible intervention at Forsyth Medical Center.

To use a well-worn phrase, it’s a classic win/win/win scenario for both the smaller community hospital, the medical center and the patient. It’s a matter of leveraging telemedicine to provide clinical expertise to smaller facilities, ensuring that each part of an ACO is able to offer patients the optimum care available.

The benefits are even greater when telemedicine is combined with EHR technology. In most healthcare settings today, stroke therapists don’t communicate well with each other. The hospital therapist’s clinical notes are rarely shared with the home health staff. And when a stroke patient has recovered enough to go to an outpatient facility, therapists there make a brand-new assessment. Yet each provider at every stage is required to have the neurologist’s approval for a plan of care. And in the ACO model, they’re all accountable for the desired patient outcome.

Clearly, telemedicine can foster the teamwork needed for success as ACOs coalesce in each community. Many large hospitals are looking for a way to “break the ice” with potential ACO partners in their areas—and telemedicine provides the perfect entrée. By putting these partnerships in place now, hospitals both large and small will soon enjoy the benefits: greater quality of care and the financial results that accompany it.

Topics: telemedicine, Stroke, hospitals, telestroke, ACO, Accountable Care Organizations

Telemedicine Made Personal

By Amy Levitt

Most televised reunions are gimmicky and superficial, but there was nothing trivial about the reunion of Sandra Bowden and Todd Samuels, M.D., at this year’s American Telemedicine Association (ATA) annual meeting in Tampa.

What the “Human Touch of Telemedicine” conference video crew captured that day was a vision of our medical future: a teleneurology advocate and stroke patient from Texarkana, Texas, getting to meet the neurologist who assessed her from his office in Baltimore, Maryland—and helped improve her outcome and recovery time. Here, in her own words, is Sandra Bowden’s account of her very personal introduction to the benefits of teleneurology.

Telemedicine Made Personal

There are many ironic moments in life, but few that compare to my stroke assessment last year.

I am director of medical post-surgical services at Christus St. Michael Health System in Texarkana, Texas—a city perhaps best known for being the hometown of one-time presidential candidate Ross Perot. Although our facility includes a 312-bed acute care hospital, Texarkana is still a fairly small city—ranking 288th in the latest U.S. census. We don’t have as many local neurologists to call as do hospitals in Boston or Los Angeles. For that reason, teleneurology has played a key role in our hospital’s campaign to become a certified stroke center.

In 2010, during an early morning meeting with the Christus stroke team, I began to feel a tingling sensation in my ear and face. It spread down my left arm, and a colleague noticed that the left side of my face was starting to droop. She quickly escorted me to the ER, where the doctor ordered a CT scan. By the time I returned to the ER, Specialists On Call, our recently implemented teleneurology provider, had been notified and neurologist Todd Samuels was speaking with my physician.

With the help of the attending nurse, Dr. Samuels began a complete neurological assessment. Throughout the entire consultation, I was the center of his attention. He answered all the questions my husband and I had, and made us both feel comfortable during a very difficult time.

Dr. Samuels told me that he believed I was having a stroke that would respond well to the clot-busting drug called tPA. He also explained the risks and benefits of the therapy. I assumed he would order the drug and be done, but he stayed and checked in on me. In a short time, I started having resolution of my symptoms—and Dr. Samuels seemed very pleased with the outcome.

I was soon transferred to the ICU, where my condition steadily improved. The left side of my face continued to droop for a few days, and I had some minor issues with gait and balance. But physical therapy resolved those conditions, and today I live a normal life with no deficits.

So when I attended the ATA annual meeting earlier this year, I had no idea that I would be meeting Dr. Samuels in person. It was a complete surprise to me. I knew I’d never forget his face, and it was wonderful to express in person how grateful I was. I couldn’t have asked for higher quality care.

I have long been a teleneurology advocate, but it wasn’t until I was the recipient of this innovative approach to care that I completely understood its importance. This is the way that medicine is going. We already have far too few specialists to meet the growing needs of people in areas of the country like mine. But I’ve experienced first-hand how teleneurology can help solve the specialist shortage and offer wonderful, life-saving care. After my encounter with SOC, I more firmly than ever see telemedicine as the wave of the future.

--Sandra Bowden, RN-BC, MSN

Topics: telemedicine, Stroke, neurology, teleneurology, emergency neurology, hospitals, telestroke, Uncategorized

THE KEY IS COLLABORATION

By Amy Levitt

Medicine, like most human endeavors, is all about collaboration. The EHR is one tool currently being touted as a way to aid collaboration by making patient data more accessible. But how does the data benefit a patient if the right specialist isn’t available to use it to guide care? EHR technology and data management are helpful only when they speed and simplify the collaborative process.

To illustrate the point, let’s take an example from the movie business. There’s a process called “looping” in movie post-production. It’s a way to add dialogue after the film has been shot. Thanks to technology, a movie director in Los Angeles can communicate with an actor in New York and a sound editor in Chicago. They watch a scene together, and the actor adds dialogue that might have gotten muddied during filming. It’s a perfect example of long-distance collaboration aided by technology.

But that type of seamless collaboration is in short supply in modern medicine, according to Ken Congdon, editor-in-chief of Healthcare Technology Online. In a recent article, he notes that the U.S. has spent some $32 billion on EHR technology, but has done little to solve an underlying problem: shortages (and uneven distribution) of health professionals. Congdon’s point is that the finest EHR system in the world achieves nothing if it doesn’t bring health professionals closer together in genuine collaboration.
Without universal access to specialists, for instance, a gap in care still exists.

This is particularly true in America’s emergency departments – and not just in remote places like Coldfoot, Alaska. In a recent survey of California hospital CEOs, more than
half are finding it difficult to obtain enough on-call specialists to meet the state’s legal requirements.

That’s why Congdon is so enthusiastic about the benefits of teleconsultations, which let ED professionals and on-call specialists transcend the most daunting geographic and financial barriers. An ED at a small critical access hospital in Idaho, for example, might find it difficult and costly to attract a full-time, on-call neurologist. Why should it have to shoulder that burden, when its physicians could speedily collaborate with a top-quality neurologist who happens to be in Boston?

Teleconsultations make sense financially and they’re achieving better outcomes as well. In one study reported in Archives of Internal Medicine, teleconsultations reduced ICU deaths by 20% and shortened the average length of stay in the ICU by more than a day.

In a wide range of industries, tele-collaboration is crucial to success. If Steven Spielberg can collaborate long-distance with his colleagues to improve something as non-essential as a movie, why shouldn’t the medical community start doing the same to close existing gaps in care and better our nation’s health?

Topics: telemedicine, healthcare, emergency department, Uncategorized, shortage of specialists

SOC Participates in the Cisco Collaboration Summit

By Amy Levitt

Author: Joe Peterson, M.D.

This past November, Joe Peterson, MD, CEO and John Moynihan, CTO were invited to participate in the Cisco Collaboration Virtual Launch Experience on the new Cisco Collaboration Website.

Enjoy!

Specialists On Call "In their words"

Topics: telemedicine, hospitals, On Call Coverage, Telepresence, Specialty Physician Shortage, Uncategorized, Cisco

Teleneurology as a Model for Telemedicine Growth: Part 2

By Amy Levitt

Author: Joe Peterson, M.D.

Teleneurology as a Model for Telemedicine Growth
The old lessons that have proven true in this new medium called telemedicine are primarily clinical ones. Quality, as Ford once said, has to be job #1. It has to be built into operating systems and managed as, or more aggressively with, distributed groups of physicians, as it does in traditional bricks and mortar institutions. There should be no reason that providers of physician services at a distance enjoy any holiday from the same accepted quality and privacy standards that traditional institutions are held to: Joint Commission accreditation, HIPAA compliance, etc. Of note, the fact that connecting to physicians remotely requires an electronic flow of information does give telemedicine a leg up in managing quality. As every patient’s case has to be committed to a system in order to be communicated to a distant facility, then that data is by definition accessible for real time review and monitoring. For example, adherence to best practices and accepted protocols are simple to measure in patient care decisions being communicated real-time through a single data system. Similarly, the logging of real-time actions into a single data system allow the review and measurement of the time required or delayed during progress against a diagnostic or clinical plan—it’s a great way to define the actionable inefficiencies in a clinical operation.

Like quality, patient satisfaction remains a prerequisite not only for good care but also for the most efficient care. Investments in telemedicine-based efficiency actually allow telemedicine-based interactions to devote more time to the patient interaction—always a factor in patient satisfaction—simply because local logistical factors have been washed from the physician’s day. This has been a happy and unexpected side effect of telemedicine. A well organized service leaves the physician with more time to speak to patients and a better ability to remain “on schedule” throughout the day, leading to many more “thank yous” than physicians working over this new medium were accustomed to receiving in the course of their traditional practice.

Teleneurology has taught new lessons about the actual role of technology in the patient interaction; enough patients have been seen that there is a body of experience now built directly from thousands of patient care interactions. One is the clear lesson that technology alone is not a solution, it’s a component. Despite the great potential of telemedicine as an adjunct to traditional care strategies, there’s a very large amount of videoconferencing equipment that was purchased with grant money and now sits in a closet covered with a dusty ER blanket. This happens because there’s a great deal more steps required to efficiently connect patients and physicians, in real time, than a couple of videoconferencing endpoints.  Teleneurology has taught us that real people and technology infrastructure—not isolated equipment purchases—are what’s required to capture the efficiencies promised by the concept of telemedicine.

Another lesson learned from these thousands of patients is that they are much faster to accept change than the physician community. As long the quality of the technology ‘connections’ are good and the service is executed with obvious professionalism, patients are accepting this new delivery mechanism and have moved on in their internal review and acceptance of telemedicine as a delivery vehicle for good care.

I was reminded very directly of this earlier this month while interviewing a family about their telemedicine experience. The daughter that was with her father during his acute stroke, was telling the other family members about the experience: “and so the emergency doctor then got the neurologist, who talked to dad and me, and he told us that dad should get this new medicine which he did, and he could move his arm and leg again before I left the hospital.”  At no point did this daughter mention to her family the qualifier that the neurologist appeared by video. She had already accepted the medium and moved on to what was important to her, that her father get better. Tens of thousands of patients have accepted this new medium, and now the traditional care system is charged with catching up.

Teleneurology has reminded us also that change is hard in clinical medicine but that with telemedicine, great speed can be obtained in capturing the numbers of patient and clinical encounters required to prove the case of this new care delivery tool. Clinical results, financial results, subject populations for clinical trials, all can be accumulated faster with 100 hospitals connected through a single telemedicine system than can be through traditional research collaborations between bricks and mortar providers. In this regard, the growth of telemedicine as a delivery mechanism will be fueled more each month by the accumulation of patient experiences.

To date, of these new and old lessons derived from the experience of teleneurology, many will form the basis for the successful expansion of telemedicine into new clinical venues.  From this regard, teleneurology has, and continues to, plow an important path for the growth of telemedicine. At the same time, teleneurology reminds us of the oldest lesson of change: all the hype over gadgets and the newest and greatest doesn’t overcome the reality that financial considerations drive many changes in healthcare. If financial models are developed that incorporate the same obvious wins for hospitals, patients, neurologists and payors that are intrinsic to the teleneurology model, telemedicine will grow. This lesson from teleneurology is perhaps one of the most important legacies that early teleneurology programs will leave in the unfolding story of telemedicine.

Topics: telemedicine, teleneurology, Physicians, Patients, Efficiency, Uncategorized