As UF moved to limit in-person activities in mid-March, the department of clinical and health psychology quickly transitioned patients of the UF Health – Psychology Specialties to telehealth appointments. In just 10 days, they converted nearly all of their care to telehealth visits.
The department was also among the first in the country to adopt telehealth for neuropsychology, emerging as a national leader in telehealth for this specialty. Faculty members published a procedure manual for neuropsychological telehealth on the Society for Neuropsychology website and provided input and suggestions to many other academic health centers and private practitioners. Russell Bauer, Ph.D., a professor in the department, participated in a national webinar for practitioners on risk management for teleneuropsychology.
Department members David Marra, Ph.D., a postdoctoral researcher, Kristin Hamlet, Ph.D., a clinical assistant professor, Bauer and Dawn Bowers, Ph.D., a professor, recently authored a systematic review of teleneuropsychology literature to examine its validity for older adults. They determined that some cognitive tests can be administered just as well via telehealth as in person.
“Prior to COVID-19, very few clinicians outside of a Veterans Affairs facility would utilize teleneuropsychology in their clinical practice,” Marra said. “Now that our field has been forced to adopt and integrate this tool into our practice, I believe aspects of teleneuropsychology will persist. While teleneuropsychology will likely never replace the gold standard, in-person evaluation, I think it will continue to be used to provide services to a wider patient population, especially those in rural populations who are typically underserved.”
Teleneuropsychology may also find a place in routine wellness screenings for older adults who may have difficulty coming into a clinic, Bauer said.
“It may find use in providing a more rapid, easily accessible means to determine, based on screening results, whether a more comprehensive evaluation is necessary,” he said. “One important aspect of teleneuropsychology is that, if used expeditiously together with in-person exams, it may reduce ‘time-to-service’ (the amount of time that elapses between referral and visit), thus potentially catching potentially treatable illnesses earlier in their course.”
Hamlet said the telehealth approach has worked well in the Perioperative Cognitive Anesthetic Network program, or PeCAN, where clinicians assess pre-surgical patients age 65 and over in order to identify older adults who may be at risk of developing cognitive problems after surgery so that clinicians can intervene to lessen the risk.
“We created a telemedicine neurobehavioral screening protocol that very closely mirrored that of our in-person assessment,” she said. “We have found a lot of success with this model. We have been able to reach more patients by being more flexible with scheduling. Many patients preparing for surgery at UF Health are traveling from far distances and may not have time to complete our PeCAN appointment on the day of their referral. We have even been able to expand our care to another pre-op clinic at UF Health since our physical location does not dictate our accessibility to patients in this model.”