Describe barriers and facilitators to telemedicine in neurology, and to examine the impact of telemedicine on neurologists’ job satisfaction.

Telemedicine facilitates patients access to specialized care and lowers patients physical and financial burden of traveling to appointments. But telemedicine is underutilized in neurology. Thus, little is known about neurologists’ experiences with telemedicine. Increased patients’ access via telemedicine may increase workload on neurologists, leading to increased stress and burnout. Exploring neurologists’ experiences with telemedicine will inform optimizing telemedicine in neurology.

A cross sectional study via a survey examined telemedicine related technological difficulties, need for technological support (IT), administrative support, neurologists’ motivation for work, change in work-life balance, and issues to improve telemedicine in neurology. Descriptive statistics were reported as percentages.

110 neurologists participated. Specialties were stroke (21.82%), epilepsy (19.09%), movement disorders (14.55%), and headache (14.55%). (50.91%) of neurologists encounter technological issues in 1%-20% of telemedicine visits. And 94.55% of neurologists rated patient- related technological issues in setting up telemedicine visit is the most common difficulty encountered. Furthermore, 57.27% of neurologists required IT support in 1%-20% of telemedicine visits. 39.09% of neurologists rated improving administrative support, 37. 27% rated integration of video-telephone calls in EMR and 27.27% of neurologists rated facilitating ordering tests as the most important issues in telemedicine in neurology. On motivation for work, 48.18% of neurologists reported no change in their motivation, 30.91% of neurologists reported somewhat decreased motivation, and only 10.00% reported somewhat increased motivation. On work-life balance, 30.00% of neurologists stated it remained the same, 26.36% stated it somewhat decreased and 23.64% stated somewhat improved work-life balance.

Technological difficulties in telemedicine are common. Improving administrative support and integration of virtual platforms in EMR are potential areas to optimize telemedicine visits. More studies are needed to examine the impact of telemedicine on neurologists’ burnout.