Background: 

Telehealth provides health care to a patient from a provider at a distant location. Before the COVID-19 pandemic, adoption of telehealth modalities was increasing slowly but steadily. During the public health emergency, rapid widespread telehealth implementation has been encouraged to promote patient and provider safety and preserve access to health care.

Evidence Acquisition: 

Evidence was acquired from English language Internet searches of the medical and business literature and following breaking news on the COVID-19 pandemic and responses from health care stakeholders, including policymakers, payers, physicians, health care organizations, and patients. We also had extensive discussions with colleagues who are developing telehealth techniques relevant to neuro-ophthalmology.

Results: 

Regulatory, legal, reimbursement, and cultural barriers impeded the widespread adoption of telehealth before the COVID-19 pandemic. With the increased use of telehealth in response to the public health emergency, we are rapidly accumulating experience and an evidence base identifying opportunities and challenges related to the widespread adoption of tele–neuro-ophthalmology. One of the major challenges is the current inability to adequately perform funduscopy remotely.

Conclusions: 

Telehealth is an increasingly recognized means of health care delivery. Tele–Neuro-Ophthalmology adoption is necessary for the sake of our patients, the survival of our subspecialty, and the education of our trainees and students. Telehealth does not supplant but supplements and complements in-person neuro-ophthalmologic care. Innovations in digital optical fundus photography, mobile vision testing applications, artificial intelligence, and principles of channel management will facilitate further adoption of tele–neuro-ophthalmology and bring the specialty to the leading edge of health care delivery.

中文翻译：

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远距神经眼科：20/20及以后的愿景

背景： 

远程医疗从远处的提供商处为患者提供医疗保健。在COVID-19大流行之前，远程医疗模式的采用正在缓慢而稳定地增长。在突发公共卫生事件期间，鼓励快速实施广泛的远程医疗，以提高患者和医护人员的安全并维护医疗服务。

取证： 

证据来自互联网上对医学和商业文献的互联网搜索，以及有关COVID-19大流行的最新新闻以及包括政策制定者，付款人，医生，保健组织和患者在内的保健利益相关方的回应。我们还与正在开发与神经眼科相关的远程医疗技术的同事进行了广泛的讨论。

结果： 

法规，法律，报销和文化障碍阻碍了在COVID-19大流行之前远程医疗的广泛采用。随着远程医疗越来越多地用于应对公共卫生突发事件，我们正在迅速积累经验和证据基础，以确定与远程神经眼科的广泛采用相关的机遇和挑战。主要挑战之一是当前无法远程进行足够的眼底镜检查。

结论： 

远程医疗是人们日益认可的医疗保健提供方式。为了我们的患者，我们的专科医师的生存以及对我们的受训者和学生的教育，采用远程神经眼科是必不可少的。远程医疗并不能代替，而是可以补充和补充亲自的神经眼科护理。数字光学眼底照相技术，移动视觉测试应用程序，人工智能以及渠道管理原理方面的创新将促进远眼神经眼科的进一步采用，并将该专业领域带到医疗保健的前沿。