Abstract Details

Title Broadband Access in Tele-Neuro-Ophthalmology

Topic Neuro-ophthalmology/Neuro-otology

Presentation(s) Neuro-ophthalmology/Neuro-otology Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 003

Background Tele-neuro-ophthalmology may alleviate provider shortage problems. Because video telemedicine requires minimum threshold bandwidths for standard-definition and high-definition video, adequate bandwidth speeds may limit tele-neuro-ophthalmology adoption.

Objective To assess broadband access for tele-neuro-ophthalmology patients in healthcare shortage areas

Design/Methods This multicenter retrospective case series compared the number of broadband providers in areas designated as Healthcare Provider Shortage Areas (HPSA) or Medically Underserved Areas (MUA) of neuro-ophthalmic patients from academic and private practices in the pre-COVID and peri-COVID era.

Results

358 neuro-ophthalmic examinations on 311 patients between March 15, 2020 and June 15, 2020 were reviewed. A control cohort (456 examinations, 444 patients) was reviewed from the same time interval in 2019. Pre-COVID, 45.8% (n=209) of office examinations were with patients living in HPSAs, 33.8% (n=154) in MUAs, and 22.4% (n=102) in both. Peri-COVID, a greater proportion of patients living in HPSAs were evaluated via telehealth (n=44, 43.6%) versus office visits (n=93, 36.2%); the opposite relationship was seen in patients living in MUAs (office n=82, 31.9%; telehealth n=31, 30.7%) and those living in both (office n=58, 22.6%; telehealth n=22, 21.8%).

While the average number of broadband providers with bandwidths amenable to standard-definition telemedicine visits was similar in all groups (average 5.3-5.5 pre-COVID, 5.1-5.7 peri-COVID), patients in HPSAs or MUAs trended toward fewer broadband providers with high-speed bandwidth (average 2.2 pre-COVID and peri-COVID) than patients not in a HPSA or MUA (2.9 pre-COVID, 3.1 peri-COVID).

Conclusions While tele-neuro-ophthalmology may expand access for patients in regions with limited healthcare resources, broadband bandwidths necessary for high-definition telemedicine are not consistently available. Further study is needed to compare high-definition telehealth capabilities between regions.

Authors/Disclosures
Divya Chauhan, MD PRESENTER	Dr. Chauhan has nothing to disclose.
Melissa W. Ko, MD, FAAN (Indiana University Neuroscience Center)	Dr. Ko has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for AAN. The institution of Dr. Ko has received research support from HRSA. Dr. Ko has received research support from IU Health.
Heather Moss, MD, PhD, FAAN (Spencer Center for Vision Research at Stanford)	Dr. Moss has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Twenty Twenty Therapeutics. Dr. Moss has received personal compensation in the range of $100,000-$499,999 for serving as a Consultant for Verana Health. Dr. Moss has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Medlink Inc. Dr. Moss has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Legal Firms. The institution of Dr. Moss has received research support from NIH. The institution of Dr. Moss has received research support from Department of Defense. The institution of Dr. Moss has received research support from Research to Prevent Blindness. Dr. Moss has received intellectual property interests from a discovery or technology relating to health care. Dr. Moss has received personal compensation in the range of $0-$499 for serving as a grant review panel with NASA. Dr. Moss has received personal compensation in the range of $0-$499 for serving as a grant review panel with National Institutes of Health. Dr. Moss has a non-compensated relationship as a Board of Directors with North American Neuro-ophthalmology Society that is relevant to AAN interests or activities.
Devin D. Mackay, MD (Indiana University)	Dr. Mackay has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Optum. Dr. Mackay has received personal compensation in the range of $50,000-$99,999 for serving as an Expert Witness for various law firms.
	No disclosure on file