Patient Satisfaction with Novel Telemedicine Platform Applied to Neuro-oncology

Introduction: The COVID-19 outbreak led to the rapid adoption of telemedicine by many specialties, including neurosurgery. Despite several telemedicine options currently available, the assessments that are specific to patients with neurological diagnoses and cranial nerve deficits remain limited. Our group has developed a novel telemedicine platform that enables patients to undergo cranial nerve and neuro-ophthalmic testing on any personal computer from their own home. In this study, we provide a detailed account of our experience using the Myelin Analytics proprietary platform in a high-volume neuro-oncology practice and share the patient satisfaction results.

Methods: This is a prospective, pragmatic, non-randomized controlled study using the Myelin Analytics telemedicine platform to perform cranial nerve and neuro-ophthalmic testing in patients greater than 18 years of age diagnosed with a brain tumor who received care at our institution from June to September 2021. The investigational arm included patients who underwent the novel Myelin Analytics assessment during their inpatient stay or outpatient visit. The control arm included patients with the diagnosis of a brain tumor using conventional telemedicine provided by Teladoc Health for their outpatient visit in the same neuro-oncology practice. Both arms were asked to complete the validated 21-question Telehealth Usability Questionnaire (TUQ) after a telehealth clinic visit. The TUQ used a Likert scale ranging from Strongly Agree to Strongly Disagree to grade patient responses. Patient satisfaction was dichotomized into favorable (included “strongly agree” and “agree” responses), and unfavorable (included “somewhat agree” to “strongly disagree”).

Results: A total of 42 patients met the inclusion criteria for the investigational arm and 34 patients for the control arm. The patients in the investigational and control arms were on average 52.2 ± 15.3 (range: 21–79) and 58 ± 13 years old (range: 29–76), respectively. The most common primary diagnoses were pituitary adenoma, cerebral metastasis, and vestibular schwannoma. Of the 42 patients that used the Myelin Analytics platform, 29 (69%) patients completed the patient satisfaction survey. The Myelin cohort achieved favorable patient satisfaction significantly more frequently in regards to access to healthcare (Q1: 96.6 vs. 73.5%, p = 0.013), clear communication with provider (Q12: 50.0 vs. 23.5%, p = 0.037) and expressing oneself effectively (Q13: 57.7 vs. 32.4%, p = 0.050).

Discussion: Current telemedicine tools focus on audiovisual communication but lack the functionalities needed to perform a comprehensive neurological examination. This novel platform enables patients to undergo cranial nerve and neuro-ophthalmic testing remotely, obviating the need for in-person examination. Our feasibility study demonstrates promising patient satisfaction results when compared with the conventional telemedicine software used by our practice. Despite a wide range of age groups and pathologies, patients were receptive to the new platform and its utility for their care.

Conclusion: Our feasibility pilot study of novel telemedicine platform that enables remote cranial nerve and neuro-ophthalmic testing shows promising results. Larger-scale studies are needed to determine its ability to detect disease progression ([Table 1]).

Publication History

Article published online:
15 February 2022