The Utility of Telemedicine in Epilepsy Care Survey

Teleneurology (TN) is the application of telemedicine to all areas of neurology. During the COVID-19 pandemic, TN provided an alternative for accessing medical care for patients. With the relaxation of COVID-related restrictions, there has been marked variability in the utilization of TN across countries and regions. With this survey, the ILAE Telemedicine Task Force aims to better understand the evolving practice in clinical epilepsy before, during, and in the early stage of the post-COVID-19 pandemic era.

The definition of TN in this survey encompasses a wide range of different services used to evaluate and manage neurological diseases, including telephone calls, synchronous (simultaneous) audio-video connections between provider and patient, asynchronous (non-simultaneous) electronic communications between provider and patient (e.g., text messaging) or diagnostic imaging systems and interpreting provider, or remote monitoring systems that make use of sensor technologies to record and transmit physiological or imaging data from the patient to provider.

There is a wide range of preferences and practices amongst medical care providers in the use of TN in managing epilepsy patients. A similar diversity also exists in the expectations and choices of patients while receiving care through TN. Further variability in the national laws of individual countries related to TN is also noted. We are therefore collecting opinions from a wide, global audience to help ILAE play a more focused role in further advocating for TN in the future.

Part 1. Basic Information
About you

Question Title

* 1. Your age:

Question Title

* 2. How do you identify?

Woman

Man

Transgender/Trans woman

Transgender/Trans man

Non-Binary

Prefer not to say

Not listed

Question Title

* 3. Your country?

Question Title

* 4. What is your occupation?

Family Doctor/General Practitioner

Paediatrician

Paediatric Neurologist

Adult Neurologist

Neurologist (all ages)

Medical/Clinical Geneticist

Genetic Counselor

Nurse practitioner

Other (please specify)

Question Title

* 5. How long have you been in practice? (years)

Question Title

* 6. What type of practice?
(Tick all that apply)

Private practice

Academic university hospital

Community hospital (non-academic)

Other (please specify)

Question Title

* 7. Your facility is in?

Urban zone

Rural zone

Question Title

* 8. Your area of expertise?

Neurology

Epileptology

Psychiatry

Internal Medicine

Neurosurgery

Neuropaediatrics

Paediatrics

Other (please specify)

Question Title

* 9. You are?

a specialist

a general practitioner

a resident/fellow

an advanced practice nurse

a nurse works under supervision or with physician

Other (please specify)

Part 2. Utilization of Teleneurology

Question Title

* 10. In your daily practice, do you utilize teleneurology?

Yes

Question Title

* 11. What proportion of your practice are completed via teleneurology? (Please estimate a percentage 0-100%), if your answer in Q10 is "No", fill in "0" here.

Before pandemic

During pandemic

After pandemic

Question Title

* 12. In your practice, do you use TN for consulting new and/or follow-up persons with epilepsy (PWE)?

	New PWE only	Follow-up PWE only	Both	I never used TN
Before pandemic	Before pandemic New PWE only	Before pandemic Follow-up PWE only	Before pandemic Both	Before pandemic I never used TN
During pandemic	During pandemic New PWE only	During pandemic Follow-up PWE only	During pandemic Both	During pandemic I never used TN
Post pandemic	Post pandemic New PWE only	Post pandemic Follow-up PWE only	Post pandemic Both	Post pandemic I never used TN

Question Title

* 13. In comparison to face-to-face patient visits, do you spend more or less time using TN at first visit for PWE?

Less

Similar

Not applicable, I don't use TN for first visit

I never used TN

Question Title

* 14. In comparison to face-to-face patient visits, do you spend more or less time using TN for follow up appointments with PWE in stable condition?

Less

Similar

I never used TN

Part 3. Reimbursement and regulation

Question Title

* 15. Is reimbursement available for teleneurology, similar to face-to-face patient visits?

	Yes	No
Before pandemic	Before pandemic Yes	Before pandemic No
During pandemic	During pandemic Yes	During pandemic No
After pandemic	After pandemic Yes	After pandemic No

Question Title

* 16. Does your country have teleneurology regulations?

Yes, initiated before the pandemic

Yes, initiated during the pandemic

Yes, initiated after the pandemic

Not yet

Question Title

* 17. Compared to the situation during the pandemic, were TN regulations in your country after the pandemic

expanded

restricted

remained the same

Question Title

* 18. Do you have to obtain agreement from the patient before the initial teleneurology visit?

written consent

verbal consent

either written or verbal consent

I never used TN

Part 4. Benefits

Question Title

* 19. What are the benefits of TN for you in your practice?
Select all that apply.

Cost saving

Time saving

Increased access to medical care for patients living in remote areas

Increased access to healthcare for patients who had difficulty in ambulating

Administrative efficiency (space saving, economize manpower...)

Increased engagement and collaboration with local health provicers

Improved patient engagement and collaboration

Increased patient satisfaction

Other (please specify)

Part 5. Limitation and barriers

Question Title

* 20. Compared to face-to-face patient visits, how challenging is it to diagnose and manage patients by teleneurology?

Less

Similar

Question Title

* 21. Have you encountered any privacy problems in utilizing teleneurology ?

Yes

I never used TN

If yes, please share your experience

Question Title

* 22. What are the barriers for the uptake of teleneurology in your practice?
Select all that apply.

Increased cost

Lack of or inadequate reimbursement

Internet/technology access

Privacy concern

Legal/indemnity/safety concern

Difficulty in establishing patient rapport

Inability to perform physical examination on patient

Less patient engagement or collaboration

Decrease patient satisfaction

Other (please specify)

Part 6. Platform used in TN and incorporation with other technology (e.g. wearable devices, digital information, AI)

Question Title

* 23. What technology/platform do you use to provide teleneurology?
Select all that apply.

Telehealth specialized platform (Mychart, VSee, Coreplus…)

Net meeting (Zoom, Webex, google meet ….)

Video connection by messaging app (Whatsapp, Line, Wechat…)

Voice call

Text message

E-mail

I never used TN

Other (please specify)

Question Title

* 24. Who is providing this service?

Hospital

Yourself

State

I never used TN

Other (please specify)

Question Title

* 25. Are they integrated with electronic health care records?

Yes

I never used TN

Question Title

* 26. Any other thoughts or suggestions?

100% of survey complete.

The Utility of Telemedicine in Epilepsy Care Survey

Question Title

* 1. Your age:

Question Title

* 2. How do you identify?

Question Title

* 3. Your country?

Question Title

* 4. What is your occupation?

Question Title

* 5. How long have you been in practice? (years)

Question Title

* 6. What type of practice?(Tick all that apply)

Question Title

* 7. Your facility is in?

Question Title

* 8. Your area of expertise?

Question Title

* 9. You are?

Question Title

* 10. In your daily practice, do you utilize teleneurology?

Question Title

* 11. What proportion of your practice are completed via teleneurology? (Please estimate a percentage 0-100%), if your answer in Q10 is "No", fill in "0" here.

Question Title

* 12. In your practice, do you use TN for consulting new and/or follow-up persons with epilepsy (PWE)?

Question Title

* 13. In comparison to face-to-face patient visits, do you spend more or less time using TN at first visit for PWE?

Question Title

* 14. In comparison to face-to-face patient visits, do you spend more or less time using TN for follow up appointments with PWE in stable condition?

Question Title

* 15. Is reimbursement available for teleneurology, similar to face-to-face patient visits?

Question Title

* 16. Does your country have teleneurology regulations?

Question Title

* 17. Compared to the situation during the pandemic, were TN regulations in your country after the pandemic

Question Title

* 18. Do you have to obtain agreement from the patient before the initial teleneurology visit?

Question Title

* 19. What are the benefits of TN for you in your practice? Select all that apply.

Question Title

* 20. Compared to face-to-face patient visits, how challenging is it to diagnose and manage patients by teleneurology?

Question Title

* 21. Have you encountered any privacy problems in utilizing teleneurology ?

Question Title

* 22. What are the barriers for the uptake of teleneurology in your practice?Select all that apply.

Question Title

* 23. What technology/platform do you use to provide teleneurology?Select all that apply.

Question Title

* 24. Who is providing this service?

Question Title

* 25. Are they integrated with electronic health care records?

Question Title

* 26. Any other thoughts or suggestions?

* 6. What type of practice?
(Tick all that apply)

* 19. What are the benefits of TN for you in your practice?
Select all that apply.

* 22. What are the barriers for the uptake of teleneurology in your practice?
Select all that apply.

* 23. What technology/platform do you use to provide teleneurology?
Select all that apply.