Abstracts

Rationale: The availability of modern technology in conjunction with increased need to serve more patients more efficiently has driven the use of telemedicine. However, outside of telestroke, there is a relative dearth of data regarding teleneurology. This study aims to review current information regarding the use of outpatient CVT for home clinic visits for patients with epilepsy. This review may enlighten the early experiences of home-CVT done at the Durham Veterans Affairs Medical Center (VAMC) during 2014. Methods: Includes a literature review of prior studies and papers on the use of CVT for outpatient care of patients with epilepsy or other neurological conditions. A PubMed search is done using the terms "tele AND neurology," "teleneurology," "telemedicine AND epilepsy" and "tele AND epilepsy." This information is compared to the pilot experiences of starting a home-CVT epilepsy clinic at the Durham VAMC during 2014. Preliminary results include answers to a twelve question patient satisfaction survey about Veterans' experiences with telemedicine. Results: There are 120 articles satisfying at least one of the four PubMed search terms. Of these, only 4 are specific to outpatient epilepsy clinics, only 2 of which are studies. Expanding to neurology in general, there are papers on outpatient CVT clinics specifically (8), reviews of teleneurology broadly (23) and costs/benefits studies (3). Reviews mostly discuss inpatient neurology and telestroke. Other common paper topics include how telemedicine changes how we communicate in neurology (15) and how technology changes how we monitor patients (37). There is a lot of anecdotal evidence suggesting that CVT, including home-CVT, is comparable to face-to-face neurology clinic visits and is more cost effective. This is echoed in preliminary survey results from patients in Durham supporting the use of home-CVT. However, there are not enough studies quantifying the different advantages and disadvantages of tele-epilepsy, particularly in the case of home-CVT. Conclusions: Home-CVT may be equally or even more effective than traditional outpatient care in the treatment of Veterans with epilepsy, but more studies are required to measure improvements and challenges.