Journal of Neurology

, Volume 265, Issue 4, pp 880–884 | Cite as

Telemedicine in general neurology: use of audiovisual consultation for on call back-up service in an acute care hospital

  • Frank Janssen
  • Mohammed Awadallah
  • Awed Alhalabi
  • Barbara Körber
  • Reinhard Lang
  • Mateusz Scibor
  • René Handschu
Original Communication



While telemedicine is in expanding use in acute stroke care, little is known about its use in general neurology, especially in acute care. We sought to investigate the feasibility and possible effects of a telemedicine device within the neurological back-up service of an acute care hospital.


In a 450 bed academic teaching hospital an experienced neurologist (EN) is on call to support the junior doctor at the hospital. Support was possible whether by standard telephone advice (TA) or by audiovisual consultations (AVC). In AVC the expert used a mobile telemedicine device and so he could establish audiovisual contact from his home to the emergency room and examine newly admitted patients. Technical and patient details including timing and diagnosis were recorded. Video and audio quality as well as impact of AVC on diagnosis was rated by the EN.


Out of about 1200 cases in off peak times, during the study period, 164 AVC including remote video examination were done (13.6%). Also 48 cases were documented by pure TA. Video quality was rated to a medium of 1.7, audio quality to 2.1. In 36 cases the audiovisual consultation was influenced by technical issues leading to cessation of AVC in 8 cases. Duration of teleconsultation was 17.3 min in AVC compared to 8.7 min for TA. The consultation diagnosis in AVC was confirmed in 74.4% of all cases compared to 57.7% in TA. AVC was rated as a valuable contribution to the diagnostic workup in 74.3% of all cases seen. In about 40% of all cases AVC was not possible due to technical or organizational reasons.


Audiovisual consultation seems to be a feasible and useful support in routine neurology back-up service of an acute care hospital. Better mobility of devices and flexibility of service is needed to improve availability and quality of this valuable tool.


Telemedicine Teleneurology Clinical neurology 



We are very grateful to Sonia Heinloth for proof-reading the manuscript.

Compliance with ethical standards

Sources of funding

The project was funded by the Bavarian State Ministry of Health and Care (DE). There are no restrictions by the funders.

Conflicts of interest

None of the authors has any conflict of interest or any financial relationship to companies or products named in this article. All authors contributed substantially to the manuscript.

Ethical standards

The study was conducted according to all common ethical standards including the rules given by the Declaration of Helsinki.

Ethical approval

The study was approved by the ethics committee of the University of Erlangen.

Informed consent

All patients participating gave their informed consent prior to inclusion in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurologyKlinikum NeumarktNeumarkt/OpfGermany
  2. 2.Emergency DepartmentKlinikum NeumarktNeumarkt/OpfGermany
  3. 3.Department of Information TechnologyKlinikum NeumarktNeumarkt/OpfGermany
  4. 4.Department of Neurology/STENO NetworkUniversity of Erlangen-NurembergErlangenGermany

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