Attitudes and barriers towards telemedicine in epilepsy care: a survey among neurological practices

Background Considering its significant potential for improving medical care, telemedicine continues to be underutilized. Despite some successful pilot projects in recent years, little is known about the barriers to the establishment and permanence of telemedicine. We conducted this study to understand the attitudes of neurologists in private practice regarding the use of telemedicine in epileptology and resulting barriers. At the same time, we present possible solutions. Methods Using an individually designed 14-item questionnaire, we prospectively surveyed all neurologists who had previously not responded or had declined participation in a transregional telemedicine pilot project regarding perceived barriers to the use of telemedicine. Results Of 58 contacted neurologists, 33 (57%) responded. The most common reasons for not using telemedicine were a perceived lack of time or a suspected excessive organizational burden (49%), concerns about technical equipment (30%), and a preference for alternative ways of intersectoral communication (30%). Feared problems related to reimbursement for telemedicine services were an obstacle for 27%. Neurologists in rural areas were significantly more willing to first request a telemedicine consultation before making a referral (p = 0.006). Conclusion The widespread establishment of telemedicine is still hindered by obstacles, most of which are organizational. The existing healthcare challenges in rural areas are a particular opportunity for the implementation of telemedicine. Most barriers to telemedicine can be solved but should be considered from the onset when designing pilot projects in order to facilitate their continuation.