Assess feasibility and acceptance of a pilot teleneurology service among patients and providers at a private hospital in Solwezi, Zambia and neurologists at the University Teaching Hospital (UTH) in Lusaka.

Low- and middle-income countries (LMICs) have the fewest neurologists per population despite having the largest burden of neurological disease.  Zambia has very few neurologists, all based at UTH, resulting in limited access to neurology care for patients, especially outside Lusaka. Telemedicine offers one avenue to improve access to specialist care.

A public-private partnership was formed between UTH neurologists and Mary Begg Health Services (MBHS) in Solwezi to initiate twice-monthly teleneurology services from March 2020. MBHS patients and their primary care providers (PCPs), located in Solwezi, were connected via Zoom with neurologists in Lusaka for live televisits.  Patients, PCPs and neurologists completed satisfaction surveys after each visit. Data collected in the first three months of this program are reported.

Of 14 planned visits, eight were conducted (57%).  The program achieved satisfaction scores of 84% (patients), 69% (PCPs) and 71% (neurologists).  Top patient satisfiers included length of time with the specialist and level of care demonstrated; for PCPs, ability to clearly follow the specialist’s instructions and confidence that the specialist understood the problem, while neurologists were satisfied they had obtained sufficient information to make a diagnosis and confidence in their diagnosis. Top dissatisfying elements for patients were their current health condition and waiting time for an appointment, for PCPs were maintenance of initial treatment plan and technical difficulties, and for neurologists were image quality and technical difficulties.

To our knowledge, this is the first example in sub-Saharan Africa of using telemedicine to leverage local expertise to provide specialist care.  Preliminary results are promising that this teleneurology program will be feasible and acceptable among patients and physicians.