Rapid Implementation of Video Visits in Neurology During COVID-19: Mixed Methods Evaluation

Area of Science:

• Neurology
• Health Services Research
• Digital Health

Background:

• Telemedicine has long been available but underutilized in neurology subspecialties.
• The COVID-19 pandemic necessitated rapid adoption of telemedicine, including video visits, in neurology.
• This created an opportunity to evaluate the feasibility and impact of video visits in ambulatory neurology.

Purpose of the Study:

• To assess the accelerated implementation of video visits in ambulatory neurology during the COVID-19 pandemic.
• Evaluate adoption rates, clinician and patient acceptability, appropriateness, and perceived sustainability of video visits.
• Understand the challenges and benefits associated with rapid telemedicine integration in neurology clinics.

Main Methods:

• Mixed-methods approach combining quantitative and qualitative data.
• Analysis of clinician-level scheduling data for adoption assessment (March 22 - May 16, 2020).
• Clinician surveys (n=48) and semistructured interviews (n=30) to assess acceptability, appropriateness, and sustainability (March - May 2020).

Main Results:

• Rapid adoption observed, with 98% of clinicians integrating video visits within 6 weeks and 92% of all visits conducted via video.
• Clinicians found video visits acceptable, though technological issues affected satisfaction.
• Video visits offered convenience for patients and families, but access to technology and language barriers were noted.

Conclusions:

• Video visits are a significant addition to ambulatory neurology care.
• They are expected to become a permanent supplement to in-person visits, enhancing patient care continuity.
• Video visits provide flexibility for both patients and clinicians in neurology practices.