The Focused Neurosurgical Examination During Telehealth Visits: Guidelines During the COVID-19 Pandemic and Beyond
Open Access
- 23 February 2021
- journal article
- research article
- Published by Springer Science and Business Media LLC in Cureus
- Vol. 13 (2)
- https://doi.org/10.7759/cureus.13503
Abstract
Objective: To provide guidelines to healthcare workers for performing a focused neurological examination via telemedicine during the coronavirus disease-2019 (COVID-2019) pandemic. Methods: We reviewed our department’s outpatient clinic visits after the implementation of a telemedicine protocol in response to the COVID-19 crisis. Crossover rates from telehealth to in-person visits were evaluated and guidelines for performing a telemedicine neurological exam were created based on the consensus of 16 neurosurgical attending providers over a four-month period. Results: From March 23, 2020 to July 20, 2020, some 2157 telehealth visits were performed in our department. Some 26 were converted to in-person visits by the provider request with the most cited reason for conversion being the need for a more detailed patient evaluation. Based on these experiences, we created a graphical tutorial to address the key components of the neurological exam with adaptations specific to the telehealth visit. Conclusions: In response to the global coronavirus pandemic, telemedicine has become an integral part of neurosurgeons’ daily practice. Telemedicine failures remain low but primarily occur due to a need for more comprehensive evaluations. We provide guidelines for the neurosurgical exam during telehealth visits in an effort to assuage some of these issues.This publication has 30 references indexed in Scilit:
- Reliability of Circulatory and Neurologic Examination by Telemedicine in a Pediatric Intensive Care UnitThe Journal of Pediatrics, 2014
- Implementing transnational telemedicine solutions: A connected health project in rural and remote areas of six Northern Periphery countriesThe European Journal of General Practice, 2013
- Accuracy of physical signs for detecting meningitis: A hospital-based diagnostic accuracy studyClinical Neurology and Neurosurgery, 2010
- Hearing Assessment—Reliability, Accuracy, and Efficiency of Automated AudiometryTelemedicine and e-Health, 2010
- Reliability and Diagnostic Accuracy of Clinical Special Tests for Myelopathy in Patients Seen for Cervical DysfunctionJournal of Orthopaedic & Sports Physical Therapy, 2009
- Does This Patient Have Hearing Impairment?JAMA, 2006
- Diagnosis of Sacroiliac Joint Pain: Validity of individual provocation tests and composites of testsManual Therapy, 2005
- Telemedicine in Emergency Evaluation of Acute StrokeStroke, 2003
- The Diagnostic Accuracy of Kernig’s Sign, Brudzinski’s Sign, and Nuchal Rigidity in Adults with Suspected MeningitisClinical Infectious Diseases, 2002
- Mini-mental state examination in neurological patients.Journal of Neurology, Neurosurgery & Psychiatry, 1984