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August 29, 2017; 89 (9) Contemporary Issues

Developing an outline for teleneurology curriculum

AAN Telemedicine Work Group recommendations

Raghav Govindarajan, Eric R. Anderson, Roger R. Hesselbrock, Ramesh Madhavan, Lauren R. Moo, Nima Mowzoon, James Otis, Mark N. Rubin, Madhu Soni, Jack W. Tsao, Scott Vota, Hannah Planalp
First published August 2, 2017, DOI: https://doi.org/10.1212/WNL.0000000000004285
Raghav Govindarajan
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Eric R. Anderson
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Roger R. Hesselbrock
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Ramesh Madhavan
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Lauren R. Moo
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Nima Mowzoon
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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James Otis
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Mark N. Rubin
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Madhu Soni
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Jack W. Tsao
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Scott Vota
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Hannah Planalp
From the Department of Neurology (R.G.), University of Missouri School of Medicine, Columbia; Intensive Neuromonitoring (E.R.A.), Decatur, GA; Specialists on Call (E.R.A.), Reston, VA; Corticare (E.R.A.), Carlsbad, CA; USAF School of Aerospace Medicine (R.R.H.), Wright-Patterson AFB, OH; Department of Neurology (R.M.), St. Joseph Mercy Health System, Pontiac, MI; Massachusetts General Hospital (L.R.M.), Boston; ENRM Veterans Hospital (L.R.M.), Bedford, MA; Telespecialists (N.M.), Fort Myers, FL; Department of Neurology (J.O.), Boston University School of Medicine, MA; NorthShore University Neurologic Institute (M.N.R.), NorthShore Health System, Glenview; Department of Neurological Sciences (M.S.), Rush University Medical Center, Chicago, IL; Department of Neurology (J.W.T.), University of Tennessee Health Science Center, Memphis; Department of Neurology (S.V.), VCU School of Medicine, Richmond, VA; and American Academy of Neurology (H.P.), Minneapolis, MN.
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Citation
Developing an outline for teleneurology curriculum
AAN Telemedicine Work Group recommendations
Raghav Govindarajan, Eric R. Anderson, Roger R. Hesselbrock, Ramesh Madhavan, Lauren R. Moo, Nima Mowzoon, James Otis, Mark N. Rubin, Madhu Soni, Jack W. Tsao, Scott Vota, Hannah Planalp
Neurology Aug 2017, 89 (9) 951-959; DOI: 10.1212/WNL.0000000000004285

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Abstract

The emerging field of teleneurology is delivering quality care to neurologic patients in increasingly numerous technologies and configurations. Teleneurology is well-positioned to address many of the logistical issues neurologists and their patients encounter today. However, formalized medical training has not caught up with this developing field, and there is a lack of formal education concentrating on the specific opportunities and challenges of teleneurology. Considering this, the American Academy of Neurology Telemedicine Work Group identified equivalencies with which any practitioner of teleneurology should be familiar. The purpose of this curriculum is not to define teleneurology or mandate where its use is appropriate, but rather to provide guidance on basic equivalencies that students, residents, and practitioners should know while practicing teleneurology. Comprehensive training in clinical bedside neurology is necessary to safely practice teleneurology and the components of this curriculum are an extension of that training. In this article, we offer a detailed discussion on the rationale for the contents of this curriculum and conclude by providing a model curriculum and an outline for evaluating residents in teleneurology.

GLOSSARY

AAN=
American Academy of Neurology;
ACGME=
Accreditation Council for Graduate Medical Education;
FSMB=
Federation of State Medical Boards

Footnotes

  • Approved by the Practice Committee on October 15, 2016, and by the AAN and AANI Boards of Directors on November 10, 2016.

  • This guideline was endorsed by the American Telemedicine Association on April 19, 2017.

  • Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.

  • Received January 25, 2017.
  • Accepted in final form June 6, 2017.
  • © 2017 American Academy of Neurology
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  • Article
    • Abstract
    • GLOSSARY
    • MODULE 1: KNOWLEDGE: INTRODUCTION TO TECHNOLOGY, BASIC IMPLEMENTATION, AND LIMITATIONS
    • MODULE 2: KNOWLEDGE: LICENSURE, MEDICOLEGAL ISSUES, AND ETHICS
    • MODULE 3: ATTITUDES: DEVELOPING A CARING ATTITUDE
    • MODULE 4: ATTITUDES: INFORMED CONSENT, PATIENT PRIVACY, AND DISCLOSURE
    • MODULE 5: SKILLS: TEACHING TELENEUROLOGY-SPECIFIC CLINICAL SKILLS
    • EVALUATION OF THE TRAINEE: MEASURING RESIDENT PERFORMANCE
    • DISCUSSION
    • DISCLAIMER
    • AUTHOR CONTRIBUTIONS
    • STUDY FUNDING
    • DISCLOSURE
    • ACKNOWLEDGMENT
    • Footnotes
    • REFERENCES
  • Figures & Data
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