Telemedicine and epilepsy care - a Canada wide survey.

BACKGROUND Canadian provinces boast one of the most sophisticated telemedicine infrastructures in the world. Feasibility of epilepsy care through telemedicine is established, but its use by practicing neurologists is unknown. The Canadian League against Epilepsy's telemedicine task force conducted this study to understand the perceptions, barriers and usage of telemedicine in epilepsy care. METHODS Using a 14 item questionnaire we prospectively surveyed all the epileptologists across Canada with regards to current use, perceived benefits and barriers to the use of telemedicine. The survey was mailed out to 76 neurologists who had a primary interest in epilepsy. RESULTS We received 39 responses (54.1%) spanning seven provinces. Majority of the responders were 50 years and over (56.4%). Although 61.5% of the physicians acknowledged a need for tele-epilepsy services, the majority (64.1%) had not used telemedicine. The most common forms of technology were videoconferencing and telephone but some physicians had also used email. Telemedicine was mainly used for clinical and educational purposes. 79.5% of physicians had access to videoconferencing equipment and 61.5% assessed that there was a need/use for clinical telehealth. The main perceived obstacles in the use of telemedicine were: lack of infrastructure support and remuneration problems followed by limitations in clinical examination. CONCLUSIONS Although widely available, telemedicine is under-utilized in epilepsy care. Most of the obstacles can be easily fixed and overcome through education and simple interventions. Partnering of epilepsy centers across Canada in the development of a comprehensive national telemedicine network would create an excellent opportunity to expand epilepsy care.