Perspective: Teleneurology Q&A and the Future of Telemedicine with Dr. Jeffrey English

teleneurology interview with dr. english


Teleneurology is one of the most impactful forms of telemedicine. By connecting virtually with remote neurologists, some of healthcare’s most fragile patients can receive lifesaving care for chronic illnesses, neurological disorders, time critical stroke recovery measures, and much more.

At VirtualMed Staff, we’re fortunate to work with some of the top teleneurologists in the field. That’s why we reached out to Dr. Jeffrey English, a Neurologist and early advocate for teleneurology, who currently serves on many of VirtualMed Staff’s neurology panels. With nearly two decades of experience in neurology, Dr. English is particularly qualified to speak about the impact of teleneurology on the lives of countless patients.

For people skeptical of teleneurology, what has your experience been in terms of delivering quality care?

As long as you know the limitations, then teleneurology is outstanding. Especially for follow up care, where you can see patients more efficiently and at a greater volume than in person. For new patients, I’d recommend having a nurse or doctor on the other end to perform more of the manual tasks. That way you don’t miss any of the nuances, but I see almost no shortcomings with telemedicine’s ability to provide quality care.    

It has been said that telemedicine is an impersonal approach to care. How do you view that and how do you approach connecting with patients virtually?

I believe telemedicine increases interactions and gives patients the feeling that they have more immediate access to the doctor versus communicating through electronic health record (EHR) messaging, especially for follow up care. The video simply allows for more points of contact, which patients enjoy.

What it boils down to is patients feeling that better quality care is being delivered. If you’re in the clinic and the doctor says, “Let’s connect with a specialist for additional information,” and you immediately use telemedicine to call a specialist, the patient is going to perceive that as better care. In the past, that patient would have received the specialist’s number and told to call them to schedule an appointment. Now, it’s immediate.

An article published in Neurology Reviews from 2016 included the quote, “Teleneurology is a disruptive approach that could change the way neurologists think about providing care, but the approach needs greater acceptance by providers, patients, and payers.”

It has been four years, is this quote still applicable today? Have you seen acceptance change from both providers and patients?

Providers and patients are all largely onboard with teleneurology now. I have a few skeptical colleagues who were firmly against it, but because of COVID, they’re now practicing telemedicine from their homes and loving every minute of it. COVID is really making everyone use telemedicine now and I’m amazed how much patients are liking it. Even the elderly and non-tech savvy, they’re loving the fact that they can receive care without leaving the house.

What was the initial pushback 5 or 10 years ago to telemedicine?

“You have to see the patient in person,” was the most common pushback. There is always going to be naysayers to any disruptive technology, but I refuse to believe that with this technology there should be any barriers to receiving expert healthcare. The technology that VirtualMed Staff uses and the service it provides, that’s the solution to removing barriers to care. Unless you can teleport me or the patient over to see each other, there’s no other way to do it.

Can you pinpoint a single innovation that was the biggest gamechanger that brought telemedicine to where it is today?

The video technology has improved significantly and the payor side [Medicare, Medicaid, and commercial payors] reimbursing for telemedicine would be two of the biggest gamechangers. Once the video technology developed to where it is today it made everything easier and more accessible. With these Payors now reimbursing for telemedicine, the technology is only going to keep expanding and improving.

Outside of stroke care, how are you seeing teleneurology deployed in emergency department settings that people might not have realized as an application of teleneurology?

There’s really not much that we can’t do in the emergency room with telemedicine. Atypical headaches, seizures, Parkinson’s, we’re able to treat a wide range of patients outside of stroke care. In fact, right now I do a lot of video screens of patients before they go to the emergency department to see if it’s something that requires a visit.

What do you think is the future of telemedicine in hospital settings?

Hospitals, clinics, and patients will have 24/7 access to these specialty centers, where they can connect with specialty and subspecialty providers instantly. These centers will allow hospitals to see more patients, receive diagnosis and treatment plans quicker, and discharge patients faster.

Can you share any personal stories or experiences you’ve witnessed that really encapsulate the value of teleneurology?

One story I love to share involves a patient I saw while they were visiting their primary care doctor. The patient had an atypical lesion on their brain, and we weren’t sure whether it was cancerous, multiple sclerosis (MS), or something else. In the old days, the patient would need to visit the hospital, receive another set of MRIs, and then wait 6 weeks to see what the next steps should be.

Fortunately, by seeing the patient through telemedicine, I was able to immediately review the MRI. Unfortunately, it was cancer, but instead of waiting 4-6 weeks to find out the diagnosis, the patient was able to receive treatment immediately the next day. We saved the patient valuable time that potentially saved their life had they waited.

I use this story a lot because it really shows just how drastically the impact of telemedicine. We knew right away what the correct diagnosis was, the treatment plan, and were able to get help to the patient immediately – all without me having to be physically in the room. 


For more information about VirtualMed Staff’s teleneurology services, please visit our page here. To read other Perspective articles from healthcare leaders and telemedicine providers, please visit here and here.