It’s not uncommon these days for employers in the appropriate types of work – office jobs and positions that largely or entirely involve computer use – to allow employees to telecommute (work mobily). That philosophy has started to catch on with how doctors interact with their patients.
With teleneurology, patients’ conditions are evaluated by way of a high-definition video link. Neurologists can review the data, x-ray images, etc. by computer from their offices or homes and consider possible treatments.
Some experts point to the advantages of teleneurology in dealing with strokes. Strokes are an alarmingly common, often very serious affliction, with about one U.S. citizen falling victim every 40 seconds.
Time is of the essence when treating stroke patients in order to save their lives or stave off as much debilitating brain damage as possible. It’s vitally important to administer tissue plasminogen activator (tPA) therapy within the first six hours of the onset of the stroke, which can greatly improve stroke outcomes. The problem is that there’s a shortage nationally of on-site ER neurologists. But with teleneurology, they don’t have to be on-site.
This remote method of evaluating neurological ailments has been around since 1999, and with steadily accelerating advances in technology over time, its usage has been skyrocketing ever since.
But it’s not entirely clear if that’s more beneficial to patients or whether it better serves hospitals’ bottom lines. Proponents say studies have revealed telemedicine in general to be reliable and accurate. Still, there’s a certain amount of controversy concerning exactly how and when it is best utilized and how it really measures up in terms of quality against old-fashioned, in-person medical evaluation.
Some neurologists see it as devaluing their services and a way for medical institutions to basically outsource the job as a means of saving money, other considerations – including patient care – being secondary.
Many American neurologists could see themselves out of a job if hospitals follow the most economically sensible route for them and enlist the teleneurology services of foreign doctors, who have lower costs of living and don’t expect salaries as high as their U.S. counterparts.
Dr. Robert S. Gould, who practices in California’s Silicon Valley, says there could be justification for teleneurology “in under-served areas.” But in bigger, more populous areas he sees it as “a disaster waiting to happen.”
“Expediency is driving up the cost and driving down the quality of medicine.”