Patient and Clinician Perspectives of New and Return Ambulatory Teleneurology Visits

ObjectiveTo evaluate the adoption and perceived utility of video visits for new and return patient encounters in ambulatory neurology subspecialties.MethodsVideo visits were launched in an academic, multi-subspecialty, ambulatory neurology clinic in March 2020. Adoption of video visits for new and return patient visits was assessed using clinician-level scheduling data from March 22 to May 16, 2020. Perceived utility of video visits was explored via a clinician survey and semi-structured interviews with clinicians and patients/caregivers. Findings were compared across 5 subspecialties and 2 visit types (new vs return).ResultsVideo visits were adopted rapidly; all clinicians (n = 65) integrated video visits into their workflow within the first 6 weeks and 92% of visits were conducted via video although this varied by subspeciality. Utility of video visits was higher for return than new patient visits, as indicated by surveyed (n = 48) and interviewed clinicians (n = 30), aligning with adoption patterns. Compared to in-person visits, clinicians believed it was easier to achieve a similar physical exam, patient-clinician rapport, and perceived quality of care over video for return rather than new patient visits. Of the 25 patients/caregivers interviewed, most were satisfied with the care provided via video, regardless of visit type, with the main limitation being the physical exam.ConclusionsTeleneurology was robustly adopted for both new and return ambulatory neurology patients during the COVID-19 pandemic. Return patient visits were preferred over new patient visits, but both were feasible. These results provide a foundation for developing targeted guidelines for sustaining teleneurology in ambulatory care.