Neurological Teleconsultations in General Practice

Do teleneurology services in rural primary care, compared with standard care, increase the proportion of patients with neurological symptoms or signs that are managed solely in general practice?In a stepped-wedge cluster randomized clinical trial, teleneurology services did not lead to an increased proportion of patients solely managed by general practice. They led to fewer referrals to ambulatory neurologists but to an increase in referrals to other specialists and hospitalization.Referral rates to ambulatory neurologists may be reduced by teleneurology, but no reduction of overall referrals, including to other specialists and hospitals, was demonstrated in this study; long-term effects remain to be evaluated.

Corresponding Author: Simone Kiel, Dr rer med, Institute for Community Medicine, Department of General Practice, University Medicine Greifswald, Walther-Rathenau-Str 11, 17475 Greifswald, Germany (simone.kiel@uni-greifswald.de).

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