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Teleregulation in Neurology: A decision-making process for neurology evaluation in a large Brazilian city
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  • Valéria Scavasine,
  • Michelle Ribas,
  • Gabriella Augustin,
  • Viviane Zetola,
  • Renata Ducci,
  • Marcos Lange
Valéria Scavasine
Federal University of Parana

Corresponding Author:[email protected]

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Michelle Ribas
Federal University of Parana
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Gabriella Augustin
Federal University of Parana
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Viviane Zetola
Federal University of Parana
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Renata Ducci
Federal University of Parana
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Marcos Lange
Federal University of Parana
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Abstract

Background: Telemedicine uses technology to deliver medical care to patients at different locations. Teleregulation (TR), a type of telemedicine, occurs when a specialist evaluates data from a general medical doctor. The aim of the current study is to analyze the use of asynchronous TR for patient referral, from primary care to a neurology specialist, in the city of Curitiba in Southern Brazil. Method: A retrospective analysis of all patients referred from primary care to neurology between September 2019 and February 2020. After a request is made by a general medical doctor for a specialist’s opinion, five neurologists with complete access to patients’ records are tasked with the decision-making. The main variables analyzed were: clinical reasons for enrollment to the TR, the TR decision, final diagnosis, indication for diagnostic procedures, and subsequent follow-up. Results: Between September 2019 and February 2020, 1035 TR sessions were performed. Headache (30.43%), epilepsy (19.03%), and dementia (15.85%) accounted for almost two-thirds of the primary care requests. One-third of the cases (33.62%) required a complementary diagnostic procedure. More than 70% of the cases did not require face-to-face assessment by a neurologist. Discussion and conclusion: Neurology is a specialty in high demand and some pathology tests require rapid decision-making. In this study, asynchronous teleneurology successfully reduced the need for in-visit consultation in 70% of cases. Further studies should identify the best opportunities for teleneurology in the city of Curitiba to facilitate better integrated care between primary care providers and neurologists.