Abstract Objective Accessing neuropsychological services, which are often centralized in urban regions, poses unique challenges to children and families in rural regions. In 2017, urban neuropsychologists and a pediatrician practicing in a rural region of New Mexico started to develop a teleneuropsychology (TeleNP) consultation service model to efficiently triage and determine a clinical course of action. This pilot project, aimed at expanding clinical access to specialized pediatric services in rural areas, evolved over the course of 2 years prior to the coronavirus disease 2019 pandemic. Method Providers earned the trust of the local community, gained understanding of pertinent sociocultural factors, and acquired knowledge of the clinical and educational concerns for the children residing in the rural community. The application of a culturally informed approach that highlights the importance of community participation and collaboration steered the decision to implement a TeleNP consultation model. By widening access to neuropsychology, this service helped to determine whether neuropsychological testing procedures were medically indicated. Results We summarize the distinct processes that needed to occur at each location to support the implementation of telemedicine. We propose a clinical service decision tree with specific criteria to help guide providers on how to triage cases in order to increase access to specialized healthcare. Conclusion The success of implementing a TeleNP consultation service hinges upon ongoing care coordination between providers, clerical staff, patients, and families with clear goals and expectations, maintenance of legal and ethical standards, and development of specific administrative and clinical processes supporting the use of TeleNP.

中文翻译：

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农村地区神经发育和获得性障碍儿童的远程神经心理咨询服务模式

摘要 目的获得通常集中在城市地区的神经心理服务对农村地区的儿童和家庭提出了独特的挑战。2017 年，城市神经心理学家和在新墨西哥州农村地区执业的儿科医生开始开发远程神经心理学 (TeleNP) 咨询服务模式，以有效地分类和确定临床行动方案。该试点项目旨在扩大农村地区专科儿科服务的临床可及性，在 2019 年冠状病毒病大流行之前的 2 年中不断发展。方法提供者赢得了当地社区的信任，了解了相关的社会文化因素，并了解了居住在农村社区的儿童的临床和教育问题。强调社区参与和协作重要性的文化知情方法的应用引导了实施 TeleNP 咨询模型的决定。通过扩大对神经心理学的访问，这项服务有助于确定神经心理学测试程序是否具有医学指征。结果 我们总结了在每个地点需要发生的不同过程，以支持远程医疗的实施。我们提出了一个具有特定标准的临床服务决策树，以帮助指导提供者如何对病例进行分类，以增加获得专业医疗保健的机会。结论 实施 TeleNP 咨询服务的成功取决于提供者、文员、患者和家属之间持续的护理协调，并具有明确的目标和期望，