Testing the Validity and Reliability of a Standardized Virtual Examination for Concussion.

Background And Objectives: We determined inter-modality (in-person vs telemedicine examination) and inter-rater agreement for telemedicine assessments (2 different examiners) using the Telemedicine Buffalo Concussion Physical Examination (Tele-BCPE), a standardized concussion examination designed for remote use.

Methods: Patients referred for an initial evaluation for concussion were invited to participate. Participants had a brief initial assessment by the treating neurologist.

Navigating the U.S. regulatory landscape for neurologic digital health technologies.

Digital health technologies (DHTs) can transform neurological assessments, improving quality and continuity of care. In the United States, the Food & Drug Administration (FDA) oversees the safety and efficacy of these technologies, employing a detailed regulatory process that classifies devices based on risk and requires rigorous review and post-market surveillance. Following FDA approval, DHTs enter the Current Procedural Terminology, Relative Value Scale Update Committee, and Centers for Medicare & Medicaid Services coding and valuation processes leading to coverage and payment decisions.

Curriculum Innovations: A Comprehensive Teleneurology Curriculum for Neurology Trainees.

Introduction And Problem Statement: As the role of teleneurology expands, it is important to prepare trainees to perform virtual encounters proficiently.

Objectives: We created a comprehensive multimodality teleneurology curriculum for residents to teach key aspects of telehealth encounters including the virtual examination and skill development across several environments.

Methods And Curriculum Description: We developed and implemented a teleneurology curriculum focused on teaching the virtual neurologic examination, measuring teleneurology competency, and providing opportunities for trainees to perform telehealth encounters in multiple settings.

Headache clinicians' perspectives on the remote monitoring of patients' electronic diary data: A qualitative study.

Objective: We assessed headache clinicians' viewpoints on potential remote access to patients' digital headache diary data and the practicalities of data utilization.

Background: With the ubiquitous nature of electronic medical records and the existence of remote monitoring (RM) for many medical conditions, there is now the potential for remote symptom monitoring for patients with headache disorders. While patients are asked to utilize headache diaries, clinicians may or may not have access to the data before patient visits, and their perspectives regarding this emerging technology are currently unknown.

The Transformation of Documenting and Coding for Neurologic Hospital Inpatient and Observation Services.

Landmark changes to documenting and coding for office or other outpatient evaluation and management (E/M) codes were implemented on January 1, 2021. To decrease clinicians' administrative burden, many documentation requirements were eliminated. In addition, major changes were made in how medical decision making and time spent on the date of the encounter are used to determine the level of service.

The use of virtual complementary and integrative therapies by neurology outpatients: An exploratory analysis of two cross-sectional studies assessing the use of technology as treatment in an academic neurology department in New York City.

Background: Prior to the COVID-19 pandemic, about half of patients from populations that sought care in neurology tried complementary and integrative therapies (CITs). With the increased utilization of telehealth services, we sought to determine whether patients also increased their use of virtual CITs.

Methods: We examined datasets from two separate cross-sectional surveys that included cohorts of patients with neurological disorders.

Neurologists' Evaluations of Experience and Effectiveness of Teleneurology Encounters.

To better understand neurologists' assessments of the experiences and effectiveness of teleneurology encounters. After completing an audio-video telehealth visit with verbally consenting patients, neurologists recorded their evaluations of the encounter. Data were analyzed using standard quantitative and qualitative techniques.

The Transformation of Documenting and Coding: Evaluation and Management Codes for Outpatient Neurology Services.

This article discusses the optimal ways to document and code for outpatient evaluation and management (E/M) codes. Since the changes for Current Procedural Terminology (CPT) codes 99202-99215 were finalized for 2021, they have been modified by the Centers for Medicare & Medicaid Services (CMS) in their Medicare Physician Fee Schedule and by technical corrections issued on March 9, 2021. The 21st Century Cures Act mandated that patients can access their notes and test results immediately.

American Academy of Neurology Telehealth Position Statement.

Telehealth services complement in-person neurologic care. The American Academy of Neurology supports patient access to telehealth services regardless of location, coverage for telehealth services by all subscriber benefits and insurance, equitable provider reimbursement, simplified state licensing requirements easing access to virtual care, and expanding telehealth research and quality initiatives. The roles and responsibilities of providers should be clearly delineated in telehealth service models.

Evaluation and Management Codes for Outpatient Neurology Services in 2021: Changes to 99202-99215.

Medical services can be conceptualized as falling into two categories: procedures and cognitive care. A procedure is defined as a surgical, medical, or diagnostic test performed on a patient, such as an x-ray, wound suture, surgery, or physical therapy treatment. Cognitive care, also known as Evaluation and Management (E/M) services, involves performing a medical history along with a physical examination and possibly ordering or reviewing diagnostic tests before formulating a medical opinion and initiating a care plan.

Tele-Neuro-Ophthalmology: Vision for 20/20 and Beyond.

Background: Telehealth provides health care to a patient from a provider at a distant location. Before the COVID-19 pandemic, adoption of telehealth modalities was increasing slowly but steadily. During the public health emergency, rapid widespread telehealth implementation has been encouraged to promote patient and provider safety and preserve access to health care.

Coding in the World of COVID-19: Non-Face-to-Face Evaluation and Management Care.

Almost all medical care in the United States is delivered with the provider and patient in immediate proximity; this model is referred to as face-to-face care. Medical services can be apportioned as procedural care (eg, surgery, radiology, or laboratory testing and others) or cognitive care, also known as Evaluation and Management (E/M) services, in which the provider formulates an assessment and plan after obtaining information from the patient's history, examination, and diagnostic tests.Providing a medical opinion and plan using the telephone as the technology that links the provider and the patient is an example of a non-face-to-face E/M service.

Rapid implementation of virtual neurology in response to the COVID-19 pandemic.

The COVID-19 pandemic is causing world-wide social dislocation, operational and economic dysfunction, and high rates of morbidity and mortality. Medical practices are responding by developing, disseminating, and implementing unprecedented changes in health care delivery. Telemedicine has rapidly moved to the frontline of clinical practice due to the need for prevention and mitigation strategies; these have been encouraged, facilitated, and enabled by changes in government rules and regulations and payer-driven reimbursement policies.

Age and sex differences in burnout, career satisfaction, and well-being in US neurologists.

Objective: To examine age and sex differences in burnout, career satisfaction, and well-being in US neurologists.

Methods: Quantitative and qualitative analyses of men's (n = 1,091) and women's (n = 580) responses to a 2016 survey of US neurologists.

Results: Emotional exhaustion in neurologists initially increased with age, then started to decrease as neurologists got older.