Tailored Online Neurosurgical Evaluation in the Outpatient Setting during COVID-19 Pandemic—The Maldives Experience

Authors

  • Ali Niyaf
  • Kiran Niraula
  • Mohamed Sajuan Mushrif Lithuanian University of Health Sciences, Lithuania
  • Tej D. Azad Johns Hopkins
  • Megha Ghimire King Edward Medical University
  • Femi Maria Varghese Lithuanian University of Health Sciences, Lithuania

DOI:

https://doi.org/10.37978/pjsm.v1i4.279

Keywords:

online, neurosurgical evaluation, tailored, covid-19

Abstract

Introduction: The recent COVID-19 pandemic has revealed important obstacles in our health care systems, including online specialist consultations. Amidst mass lockdowns and social distancing, we observed the importance of developing a consistent method of performing effective neurological examinations that yield accurate results in a time efficient manner.

Objectives: To describe our experience in the Maldives of performing effective online neurological examination.

Methodology: We designed and implemented a platform for patients to register for online consultation, collected a comprehensive neurological history, including pictures/scroll-videos of past radiological reports, and guided the patient and their aide through neurological examination methods- both verbally through online video consultation and informative pictorials that depict exactly how-to perform said examinations.

Conclusions: Neurological examinations are time consuming, detailed and require skill and expertise to be performed appropriately. Yet, can be customized and adapted to be performed remotely. Proper guidance by examiner and assistance by family or friend with use of pictorials can conclude a thorough online examination.

Downloads

Download data is not yet available.

References

Mehrotra A, Chernew M, Linetsky D, Hatch H, Cutler D. What impact has COVID-19 had on outpatient visits. To the Point. 2020;23. Available from: doi: 10.26099/ds9e-jm36.

Lloyd H, Craig S. A guide to taking a patient’s history. Nurs Stand. 2007;22(13):42. Available from: doi:10.7748/ns2007.12.22.13.42.c6300

Clinical epidemiology team. Stroke-Card; 2020 [cited 2020 Aug 6]. Available from: https://clinicalepi.i-med.ac.at/research/strokecard/.

Glass A, Zazulia A. Clinical Skills: Neurological Examination; 2011 Feb 5 [cited 2020 Aug 6]. Available from: https://neuro.wustl.edu/Portals/Neurology/Education/PDFs/Neurological-Exam-Lecture-Notes.pdf.

Gellman MD, Turner JR, editors. Encyclopedia of behavioral medicine. Springer New York; 2013.

Nasreddine Z, Phillips N, Bedirian V et al. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment. J Am Geriatr Soc. 2005;53(4):695-699. Available from: doi:10.1111/j.1532-5415.2005.53221.x

Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. The Lancet. 1974;304(7872):81-84. Available from: doi:10.1016/s0140-6736(74)91639-0

Walsh F, Hoyt W, Miller N. Walsh And Hoyt’s Clinical Neuro-Ophthalmology. 6th ed. Williams & Wilkins; 2005:89-90.

Marey H, Semary N, Mandour S. Ishihara Electronic Color Blindness Test: An Evaluation Study. Ophthalmic Res. 2015;3(3):67-75. Available from: doi:10.9734/or/2015/13618

Mattle H, Mumenthaler M, Taub E. Fundamentals of Neurology, An Illustrated Guide. 2nd ed. Thieme; 2017:19-52.

Jameson J, Kasper D, Longo D, Fauci A. Harrison’s Principles Of Internal Medicine. 20th ed. McGraw-Hill; 2018:3025-3030.

Blumenfeld H. Neuroanatomy Through Clinical Cases. 2nd ed.; 2010:49-79.

Biller J, Gruener G, Brazis P. Demyer’s The Neurologic Examination. 7th ed. McGraw-Hill; 2017:4, 262.

Clinical epidemiology team. Stroke-Card; 2020 [cited 2020 Aug 6]. Available from: https://clinicalepi.i-med.ac.at/research/strokecard/.

Goldberg C. UC San Diego’s Practical Guide to Clinical Medicine; 2018 [cited 2020 Aug 6]. Available from: https://meded.ucsd.edu/clinicalmed/neuro2.html.

Campbell W, Barohn R. Dejong’s The Neurologic Examination. 7th ed. Lippincott Williams & Wilkins; 2012:413.

Moini J, Piran P. Functional And Clinical Neuroanatomy: A Guide for Health Care Professionals. Academic Press; 2020:511-513

Wilkinson I, Raine T, Wiles K, Goodhart A, Hall C, O’Neill H. Oxford Handbook Of Clinical Medicine. 10th ed. Oxford University Press; 2017:86.

Russell S, Triola M. The Precise Neurological Exam. Informatics; 2006 [cited 2020 Aug 6] Available from: https://informatics.med.nyu.edu/modules/pub/neurosurgery/coordination.html.

Nass S, Gostin L, Levit L. Reforming the HIPAA Privacy Rule. JAMA. 2009;301(13):1373. Available from: doi:10.1001/jama.2009.424

McCormack M. Is Zoom HIPAA Compliant for Video Conference?. Compliancy Group. 2020 [cited 2020 Aug 6]. Available from: https://compliancy-group.com/is-zoom-hipaa-compliant/.

Zoom; 2020 [cited 2020 Aug 6]. Available from: https://zoom.us/docs/doc/Zoom-hipaa.pdf.

HIPAA Compliant Instant Messaging. HIPAA Journal. 2020 [cited 2020 Aug 6]. Available from: https://www.hipaajournal.com/hipaa-compliant-instant-messaging/.

Hughes P, Latino R, Kelly T. Preventing Patient Identification Errors. PSQH. 2017. https://www.psqh.com/analysis/preventing-patient-identification-errors/.

Martin R, Fanaroff A, Walsh M. Fanaroff And Martin’s Neonatal-Perinatal Medicine. Elsevier Health Sciences; 2010:86.

Greenhalgh T, Vijayaraghavan S, Wherton J, et al. Virtual Online Consultations: Advantages and Limitations (VOCAL) study. BMJ Open 2016;6

Published

2021-03-10

How to Cite

Niyaf, A. ., Niraula, K. ., Mushrif, M. S. ., Azad, T. D. ., Ghimire, M. ., & Varghese, F. M. . (2021). Tailored Online Neurosurgical Evaluation in the Outpatient Setting during COVID-19 Pandemic—The Maldives Experience. Pakistan Journal of Surgery and Medicine, 1(4), e279. https://doi.org/10.37978/pjsm.v1i4.279