Teleneurology for epileptic patient follow-up a pilot trial at Hospital de San José. Bogotá DC, Colombia

Teleneurología para el seguimiento de pacientes epilépticos prueba piloto en el hospital de San José. Bogotá DC, Colombia

The use of teleneurology was determined by factors such as a great demand of neurological follow-up services for epileptic patients and the fact that most neurologists reside in the main cities. Overall Objective: to evaluate patient satisfaction rates with teleneurology and the human and technical resources needed for the implementation and evaluation of this consultation system. Methods: a pilot trial was conducted between January and March 2012. The inclusion criteria were: patients older than 18 years with confirmed diagnosis of epilepsy and an informed consent. The sample was divided into the standard face to face consultation group (GI) and the teleconsultation group (GIi). Results:GI included 15 patients and 2 were excluded. In GIi, only 7 met the inclusion criteria out of 26 patients. The patient satisfaction rate in GI was 92% and in GII 72%. Discussion: GII evidenced high satisfaction rates; the trial defines the human and technical replication requirements for this system. Conclusions: telemedicine is a feasible strategy for improving the scope of neurology services in patients with confirmed diagnosis of epilepsy for it has a high level of acceptability. Further trials in a larger population for longer periods must be conducted to confirm cost effectiveness and patient and neurologist satisfaction rates for this activity.

1. Public Health principies and neurological disorders. In: Neurological Disorders: Public Health Challenges.Geneva: WHO; 2006. p. 7-26.
2. Matiz Camacho H. El futuro de la medicina con equidad en Colombia : la Tele­ medicina. Rev. Col. Cardiol. 2007;14:l-8.
3. Velez A, Eslava-Cobas J. Epilepsy in Colombia: epidemiologic profile and clas­ sification of epileptic seizures and syndromes. Epilepsia. 2006; 47(1): 193-201.
4. Kindelán Baro M. La Telemedicina, su estructura, objetivo y ventajas. Santiago de Cuba: Instituto Superior de Ciencias Médicas; 2005
5. Bonnardot L, Rainis R. Store-and-forward telemedicine far doctors working in remate areas. J Telemed Telecare. 2009;15(1):l -6.
6. Viloria C. Tecnologías de la información para la educación, investigación y apli­ cación en el área de la salud. Bondades y retos. Salud Uninorte 2009; 25(2):331- 349.
7. Organismo Andino de Salud. Aplicaciones de telecomunicaciones en salud en la subregión andina: Telemedicina [monografía en Internet]. Lima: 2011. [citado 24 Sep. 2012]. Disponible en: http://www.orasconhu.org/sites/default/fi.lesfTele­ medicina.pdf
8. Colombia. Ministerio de comunicaciones. Programa comparte! de telecomunica­ ciones sociales [monografía en Internet]. Bogotá: El Ministerio; 2004. [citado 24 Sep. 2012]. Disponible en: http://www.itu.int/lTU-D/fg7/case_1ibrary/case_stu­ dy_2/Americas/Columbia.pdf
9. Colombia. Ministerio de Proteccion Social . Resolución No. 1448 del 8 de mayo de 2006 Por la cual se definen las Condiciones de Habilitación para las institucio­ nes que prestan servicios de salud bajo la modalidad de Telemedicina
10. Stanberry B. Legal and ethical aspects of telemedicine. J Telemed Telecare. 2006;12(4):166-75.
11. Rey-Moreno C, Reigadas JS, Villalba EE, Vinagre JJ, Fernandez AM. A sys­ tematic review of telemedicine projecls in Colombia. J Telemed Telecare. 2010;16(3):114-19.
12. La necesidad de realizar estudios de viabilidad y evaluaciones de impacto en los proyectos de telemedicina. En: Pan American Health Organization. Bases meto­ dologicas para evaluar la viabilidad y el impacto de proyectos de telemedicina; 2001. p. 4-6.
13. Pradilla AG, Yesga AB, Lean-Sarmiento FE. [National neuroepidemiological study in Colombia (EPINEURO)]. Rev Panarn Salud Publica 2003; 14(2): 104-11.
14. Keenan NL, Shaw KM. Coronary heartdisease and stroke dealhs - United States, 2006. MMWR Surveill Sumrn .2011;60 Suppl:62-66.
15. Freeman WD, Yatz KA. The future of neurology.Neurol Clin. 2010;28(2): 537-61.
16. Chua R, Craig J, Esmonde T, Wootton R, Pallerson Y. Telemedicine far new neurological outpatients: putting a randomized controlled tria! in the context of everyday praclice. J Telemed Telecare. 2002;8(5):270-73.
17. Craig J, Patterson V, RusseU C, Wootton R. Interactive videoconsultation is a feasible method far neurological in-patient assessment. Eur J Neurol. 2000; 7(6):699-702.
18. Demaerschalk BM. Telestrokologists: treating stroke patients here, there, and everywhere with telemedicine. Semin Neurol. 2010;30(5):477-9I.
19. Misra UK, Kalita J, Mishra SK, Yadav RK. Telemedicine in neurology: underuti­ lized potential. Neurol India. 2005;53(1):27-31.
20. World Health Organization. Neurologist. Atlas country resources far neurologi­ cal disorders. Geneva: WHO; 2004.
21. Meinardi H, Scott RA, Reis R, Sander JW. The treatrnent gap in epilepsy: the current situation and ways forward. Epilepsia. 2001;42(1):136-49.
22. Ganapathy K, Ravindra A. Telemedicine in neurosciences. Stud Health Technol Inforrn. 2008;131:149-69.
23. Rasmusson KA, Hartshorn JC. A comparison of epilepsy patients in a traditional ambulatory clinic and a telemedicine clinic. Epilepsia. 2005; 46(5):767-70.
24. Ahmed SN, Mann C, Sinclair DB, Heino A, Iskiw B, Quigley D, Ohinmaa A. FeasibiJity of epilepsy follow-up care through telemedicine: a pilot study on the patient's perspective. Epilepsia. 2008 Apr; 49 (4): 575-85.
25. Ahrned SN, Mann C, Sinclair DB et al. Feasibility of epilepsy follow-up care through telemedicine: a pilot study on the patient's perspective. Epilepsia. 2008; 49(4):573-85.
26. Elger CE, Burr W. Advances in telecommunications concerrting epilepsy. Epi­ lepsia. 2000;41 Suppl 5:S9-12.
27. Bazil CW. Comprehensive care of the epilepsy patient--control, comorbidity, and cost. Epilepsia. 2004;45 Suppl 6:3-12.
28. Levav I, Stephenson C, Theodore W. Epilepsy in Latin America and the Caribbean: a survey on needs and resources. Rev Panarn SaludPublica. 1999; 6(5):342-45.