Evidence map›Paper›PMID 34163548›Full record

ArticleThe Neurohospitalist2021

Teleneurology Comprehensive Inpatient Consultations Expedite Access to Care and Decreases Hospital Length of Stay.

Robert McCormick, Juan Estrada, Cynthia Whitney, Mona Hinrichsen, Patrick T Lee, Adam B Cohen, Lee Schwamm, Marcelo Matiello

Abstract read
In one paragraph

Article in The Neurohospitalist, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Review
  4. Article
  5. Article
  6. Neuroethics in the Era of Teleneurology.Seminars in neurology · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Robert McCormickDepartment of Neurology, Boston Medical Center, Boston University, Boston, MA, USA.
Juan EstradaDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Cynthia WhitneyDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Mona HinrichsenDepartment of Medicine, North Shore Medical Center, Salem, MA, USA.
Patrick T LeeDepartment of Medicine, North Shore Medical Center, Salem, MA, USA.
Adam B CohenDepartment of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Lee SchwammDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Marcelo MatielloDepartment of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.ORCID https://orcid.org/0000-0001-9753-8816

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeWhile the successful provision of telestroke care has been well documented in the literature, studies on the impact of comprehensive teleneurology service (TN) to hospital measures are lacking. We evaluated 3 traditional health services metrics of hospital performance: time from consult request to consult completion, inpatient length of stay (LOS), and the rate of patients transferred for tertiary care.

methodsMedical records (n = 899) from 3 community hospitals and our TN consultation database were retrospectively reviewed during the 2 years before (n = 703, 3 hospitals) and 4 months (n = 2 hospitals) to 2 years (n = 1 hospital) after implementation (n = 196) of a TN program for routine and urgent consult requests. Consult order time, consult completion time, total length of stay and discharge disposition were compared across the pre-TN implementation group, which consisted of in-person consultations and the post-TN implementation group, which consisted of TN consultations only.

resultsAfter TN implementation, median length of stay decreased 28% (3.9 vs. 2.8 days, p < 0.0001) and median time from consult order to consult completion decreased by 74% across all diagnoses (5.8 vs. 1.5 hours, p < 0.0001). There were no significant differences in the percentage of patients discharged home (52.3% vs. 56.1%, p = 0.10) or transferred to tertiary care (6.1% to 9.2%, p = 0.10).

conclusionsImplementation of TN program was associated with significant reductions in LOS and time to consultation completion without an increase in shunting of patients to more advanced facilities. Further research is warranted to confirm these findings in independent cohorts and other models of teleneurology delivery.

Indexed as

clinical specialtyneurohospitalistoutcomespatient outcomestechniquestelehealthtelemedicineteleneurology

Identifiers

PMID34163548
PMCPMC8182406

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.