A new study supported by the American Academy of Neurology (AAN) has found that, for people who see a neurology clinician for the first time, being seen virtually versus in person made no difference regarding how soon they required further care. The study was published today in Neurology.
“While telemedicine has been shown to improve access to care for people in rural areas and for those without transportation—and telemedicine has received high satisfaction scores from both clinicians and patients—not a lot of research has been done on how effective virtual visits are compared to in-person visits, especially for new neurology patients,” said study author Chloé Hill (University of Michigan, Ann Arbor, USA). “We looked at how often people had a follow-up neurology clinic visit, or needed to go to the emergency department or the hospital, within three months after their first visit to see if virtual visits led to a need for more follow-up evaluations or more serious problems than in-person visits.”
For the study, researchers reviewed electronic medical record data from three academic health systems to identify first-time patient visits with a neurology clinician between September 2020 and December 2021—during the COVID-19 pandemic.
Researchers matched 8,202 virtual visits to 8,202 in-person visits. Participants were matched for factors including age, sex and previous healthcare use. They were then grouped into categories based on the reason for their visit, such as dementia, epilepsy, headache, peripheral neuropathy, Parkinson’s disease, multiple sclerosis, stroke, sleep disorders and other conditions.
Comparing virtual visits and in-person visits, researchers found no difference in follow-up visits to a neurology clinic, either virtual or in person, with a quarter of all patients having a second visit within 90 days. Visits to the emergency department and hospitalisations were also similar within 90 days.
When looking at individual conditions, the 90-day clinic visit follow-up rate was higher after in-person visits for dementia, while 30- and 90-day follow-up was higher after virtual visits for Parkinson’s disease and multiple sclerosis, and 90-day follow-up was higher after virtual visits for headache. In stroke, there were more hospitalisations within 90 days following a virtual visit.
“Our results suggest that virtual visits are appropriate for an initial neurologic evaluation across a range of conditions,” Hill added. “We found that neurology patients with initial virtual visits do not typically experience higher rates of trips to the emergency department or hospitalisations. Future research should investigate more fully if people with different conditions may benefit more from one particular type of visit.”
A limitation of the study was the fact that the data were from the early months of the COVID-19 pandemic, before a vaccine was available and when care‑seeking behaviour may have been affected. According to Hill, data from more recent years may show different patterns of medical care use and should be analysed in future studies.
