Teleneurology and telephone consultations have long been used in neurology.1 2 There is a lack of research data on using remote consultations for new neurology outpatients and only low-level evidence for their use in general practice. Remote consultations provide a mechanism for neurology care during the COVID-19 pandemic. Switching from face-to-face new appointments to remote (telephone or video) consultations allows continued provision of neurological services to patients while reducing hospital footfall; this could limit the spread of COVID-19 and avoid exposing vulnerable patients who attend the clinic to unnecessary risk. We have built this document using advice from the UK General Medical Council (GMC) on remote consultations.3 However, the GMC’s advice is not wholly applicable in the setting of COVID-19; their safety concerns are mostly mitigated by the fact that we are the patient’s regular healthcare provider, with access to their notes and referral letters. The GMC also makes specific provision for departure from established procedures to care for patients in the highly challenging but time-bound circumstances of the peak of an epidemic.3 Given that the clinical history provides the greatest part of the information that leads to a diagnosis,4 remote consultation should be able to help many patients. In general practice, remote consultations were not associated with any statistically significant change in visits to the Emergency Department or any differences in rates of admissions or of patient satisfaction.5 However, remote consultations have been linked to more repeated visits: an average of two additional contacts for every 10 patients.6 Although a quarter of all patient consultations now occur on the telephone in general practice, there is no evidence base upon which to inform clinician training in this skill.7 This paper aims to help neurologists to conduct remote consultations, particularly in relation to the current …

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COVID-19：切换到远程神经科门诊咨询

远程神经病学和电话咨询长期以来一直用于神经病学。1 2 缺乏对新神经病学门诊患者使用远程咨询的研究数据，并且只有低水平的证据表明它们在一般实践中的使用。远程会诊为 COVID-19 大流行期间的神经病学护理提供了一种机制。从面对面的新预约转换为远程（电话或视频）咨询，可以继续为患者提供神经学服务，同时减少医院人流量；这可以限制 COVID-19 的传播，并避免使就诊的弱势患者面临不必要的风险。我们根据英国综合医学委员会 (GMC) 关于远程咨询的建议编写了本文档。3 但是，GMC 的建议并不完全适用于 COVID-19 的情况；由于我们是患者的常规医疗保健提供者，可以访问他们的笔记和推荐信，因此他们的安全担忧在很大程度上得到了缓解。GMC 还特别规定了在流行高峰期极具挑战性但有时限的情况下，偏离既定程序来照顾患者。 3 鉴于临床病史提供了导致诊断的大部分信息， 4 远程会诊应该可以帮助很多患者。在一般实践中，远程会诊与急诊科就诊的任何统计显着变化或入院率或患者满意度的任何差异无关。 5 然而，远程会诊与更频繁的就诊有关：平均额外增加两次每 10 名患者的接触者。