In this article, we will be discussing the importance of Neurology. We all have to understand that we all have to age gracefully and the aging population is the key driver to understand the rising need and importance of Neurologists.
If we look at the data, we can clearly see that we have significantly improved our life span over the last decades. In the last century, our average lifespan was 30 years but now with the breakthroughs in technology, we live up to 83 years on average. According to the United Nations, by the year 2050, there will be around 2.1 billion people who are above the age of 60. That would be one-fourth of the world population. But anyone above the age of 60, will have multiple morbidities and the most common of them are cardiovascular disorders in which the stroke is a subset and then malignant neoplasms, chronic respiratory stress, etc.
In neurology, we see a significant curve of different disease burdens at different age brackets (1). For a child or an infant, we usually see encephalitis and meningitis, but as we grow older, the key issues become migraine, multiple sclerosis, headaches, and for old age people, stroke and Alzheimer’s take over. And that makes people live with disability and without dignity. So, we definitely need more neurologists to take care of our aging population.
Unfortunately, we’re going to have a significant lack of neurologists as compared to what we need. As a matter of fact, by 2025, we’re going to have a 19% shortfall. That’s literally four years from now and that’s only going to increase. And this is not the whole story. The bigger issue is that if we look at the below image, the rural areas (that are shaded red) are the areas that we need the most amount of care but will be lacking the most (2). There’s going to be a lack of neurologists everywhere except for a very small corridor in the northeastern region. So, there will be a significant mismatch between demand and supply. So, how do we provide neurological care in those affected areas? There’s only one solution and that is TeleNeurology. With telehealth, we can virtually care for these patients and help them appropriately.
The lack of neurologists signifies the importance of virtual care, and we need to augment the presence of neurologists virtually. This will help them hop from one hospital to another thereby saving their driving time, parking time, etc., It’s ridiculous that we are still trying to fight this idea that in-person care is better than virtual care. We need to understand that both are the same and so it’s better to use virtual care at least for initial evaluations. With the help of televisit, physicians are able to advise their disabled patients if it’s worth their time to have an in-person visit. And with the recent advancements in technology, it’s possible for us to bring stuff like labs, x-rays, and even portable MRIs, to different rural populations. So we need to remove these barriers, especially traveling, and make virtual care, especially teleneurology universal.
One of the big issues behind physician burnout in general and in neurology is the documentation burden. Interestingly, virtual care is time-based and therefore we’re reimbursed not because of the documentation, but because of the time we spent with the patient, which is amazing! And therefore virtual care should be universal. We need to add physician extenders like nurse practitioners and physician assistants in places where there will be a significant need for Neurologists.
To achieve teleneurology success, telehealth companies need to understand that it can be divided into these two areas:
- Acute Care Setting
- Chronic Care Setting
In acute care settings, we need to concentrate on the systems of care, because we’re taking care of stroke patients, neuro ICU patients, or inpatient neurology concepts. In that setting, we need to understand how the systems of care will be evaluated, not just the physician but also need to concentrate on the three C’s — Collaboration, Communication, and Crew (teamwork).
Now, when their stroke is initiated, it could be in a primary stroke center, which needs to be transferred to a comprehensive stroke center for thrombectomy. So what we need to concentrate on is a secure messaging platform or remote teleradiology, viewability of EMR through different platforms so that we can provide timely care. And these require protocols and systems of care thinking. Where teleneurology is part of the core team not in addition to the team. And that’s where VeeMed comes in because we actually help healthcare systems provide solutions and not just a platform.
In chronic care settings, a multi-party view is extremely important. Because in situations where the patient had a stroke, cognitive decline, or Alzheimer’s disease, we might need more information that might probably be with the patient’s daughter, son, or even granddaughter, and we should be able to get in touch with them directly through the multi-party system. We also need to make sure it’s easy for elderly people to get on board and get the help they need with just a single click. There should be either SMS, text, or even an email reminder system. And more importantly, there should be an educational platform due to which not just the patient, but even his/her family members are prepared for it.
So, for teleneurology success, the systems must be robust, it should be hard to eat because the problem really is again, their tremors and they’re going to hold on those tablets or stuff and they can fall, etc. So it has to be a very robust system, it needs to be reliable, we cannot have this problem with different patients. And it has to be very rapid. Again, we always concentrate on how YouTube, Twitter, and LinkedIn are robust, reliable systems, and so we need to be better, if not the same. In addition to that, PTZ camera system should be excellent in quality especially in the acute care setting, because we need to do Pupillary, Tremors, and Gait exams. UI should not only be better for the patient but also should be good for the physicians. It should be an excellent UI system with significant speed and be compatible with any operating system.
These are all the features that we have built-in VeeMed as well. This is basically an all-in-one care platform. And the idea behind this is that we have all the features in a specific need scenario so that no one is overpaying for their needs. So we have a platform that includes inpatient, outpatient, and remote patient monitoring with solution building systems of care approach for ICU, stroke care, etc. And then we have physician services like teleneurologist, telepsychiatry, telehospitalist, teleicu, and even teleneurosurgeon physician. I’m very grateful to be part of this excellent team at VeeMed.
Thank you so much!
- GBD 2017 US Neurological Disorders Collaborators et al. “Burden of Neurological Disorders Across the US From 1990–2017: A Global Burden of Disease Study.” JAMA neurology (2020): n. pag. Web. 30 Jan. 2021.
- Dall, T. M. et al. Supply and demand analysis of the current and future US neurology workforce. Neurology 81, 470–478 (2013).