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REMOTE-Neuro: co-produced recommendations to optimise remote neurology.

Patricia Fuller1,2, Sarah Fearn1,2, Sally Dace3

  • 1University of Southampton, Southampton, UK.

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Summary

Stakeholders value remote neurology care for convenience but raise concerns about quality and equity. The REMOTE-Neuro framework offers recommendations for safe, equitable, and sustainable remote neurology services.

Keywords:
CLINICAL NEUROLOGYHEALTH POLICY & PRACTICE

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Area of Science:

  • Neurology
  • Health Services Research
  • Digital Health

Background:

  • Remote neurology outpatient care offers accessibility and convenience.
  • Integration challenges persist between remote and in-person care models.
  • Stakeholder perspectives are crucial for optimizing remote healthcare delivery.

Purpose of the Study:

  • To examine stakeholder experiences with remote neurology outpatient care.
  • To co-produce an evidence-based framework for safe, equitable, and sustainable remote neurology services.
  • To address challenges in remote care quality, privacy, and equity.

Main Methods:

  • Inductive thematic analysis of national survey free-text responses from patients, carers, and neurologists (N=3056).
  • Validation through co-production workshops and interviews with patients, carers, and healthcare professionals (N=43).
  • Triangulation and refinement of themes to generate stakeholder-endorsed recommendations.

Main Results:

  • Participants appreciated flexibility but noted concerns regarding clinical quality, privacy, and equity.
  • Remote care requires distinct training and improved digital infrastructure.
  • A novel challenge identified is the perception of remote appointments as less legitimate, impacting engagement and equity.
  • Five key domains were identified: patient-centered care, specialist considerations, clinical safety, capacity/sustainability, and operational efficiency.
  • These findings informed the REMOTE-Neuro framework.

Conclusions:

  • Remote care offers significant benefits but faces unresolved integration issues.
  • The REMOTE-Neuro framework provides actionable recommendations for optimizing remote neurology practice.
  • The framework is grounded in extensive stakeholder input and aligned with NHS transformation priorities, offering a transferable model for other specialties.