An Empirical Analysis of the Current Need for Teleneuromedical Care in German Hospitals without Neurology Departments.

Indroduction. At present, modern telemedicine methods are being introduced, that may contribute to reducing lack of qualified stroke patient care, particularly in less populated regions. With the help of video conferencing systems, a so-called neuromedical teleconsultation is carried out. Methods. The study included a multicentered, completely standardized survey of physicians in hospitals by means of a computerized on-line questionnaire. Descriptive statistical methods were used for data analysis. Results. 119 acute hospitals without neurology departments were included in the study. The most important reasons for participating in a teleneuromedical network is seen as the improvement in the quality of treatment (82%), the ability to avoid unnecessary patient transport (76%), easier and faster access to stroke expertise (72%) as well as better competitiveness among medical services (67%). The most significant problem areas are the financing system of teleneuromedicine with regard to the acquisition costs of the technical equipment (43%) and the compensation for the stroke-unit center with the specialists' consultation service (31%) as well as legal aspects of teleneuromedicine (27%). Conclusions. This investigation showed that there is a high acceptance for teleneuromedicine among co-operating hospitals. However these facilities have goals in addition to improved quality in stroke treatment. Therefore the use of teleneuromedicine must be also associated with long term incentives for the overall health care system, particularly since the implementation of a teleneuromedicine network system is time consuming and associated with high implementation costs.