A pilot study of telemedicine for new neurological outpatient referrals

We investigated whether new patients attending a neurological outpatient cl inic could be safely managed by neurologists at a distance, using a video-l ink. In Northern Ireland, a video-link, transmitting at 384 kbit/s, was set up between a neurological centre and a small rural hospital 140 km away. T wenty-five unselected patients who had been referred by their family doctor were assessed by a neurologist using the telemedicine link and then immedi ately by another neurologist face to face. Examiners were blinded to the re sults of each other's assessment. In 24 cases the diagnoses made after the telemedicine and face-to-face examinations were identical. There were minor differences between the type and number of investigations requested, and t he requirements for treatment and follow-up between the two groups. Disposa l method was the same in 21 of the cases. No major organizational difficult ies were encountered during the study. The study showed that neurologists c an deliver outpatient neurological care to distant patients using telemedic ine. This has the potential to allow access to assessment for the large num ber of neurological outpatients who might otherwise be denied it.