Study backs telemedicine for assessing concussions

Remote consultation can determine whether rural athletes can return to play
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Telemedicine can play a key role in providing access to a concussion specialist in rural areas, according to a study by Mayo Clinic researchers in Phoenix.

A 2011 Arizona law requires athletes suspected of having a concussion to be cleared to return to play by a concussion specialist, which poses a problem in rural communities. The study, published in the journal Telemedicine and e-Health, follows the treatment of a 15-year-old soccer player at an 89-bed regional facility without direct neurological support operated by the Mayo Clinic. Though he was discharged and returned to soccer practice, the player reported headaches with more than mild exertion. Through a telemedicine hookup with a specialist in Phoenix, he was advised to refrain from play until he underwent a face-to-face evaluation with a specialist.

"The telemedicine platform is ideal for providing rapid access to a concussion specialist to facilitate sideline assessments and return-to-play decisions at the professional and amateur levels, especially taking into account recent guidelines imposed by the National Football League to seek the opinions of independent neurologists in the assessment of concussed football players," the authors wrote. They pointed to the value telemedicine has demonstrated in the evaluation of stroke and traumatic brain injury, an area focus for the military healthcare system.

While a remote desktop or laptop on a cart could be used as a mobile interface for telemedicine, tablets and smartphones offer even more mobility. Indeed, 16 NFL teams this season are using iPads to conduct concussion assessments, comparing post-injury assessments with a baseline. That number that is expected to grow to all 32 teams for the 2013 season.

Key requirements for mobile devices used to access concussion data would be encrypted communication to ensure patient privacy, access to Wi-Fi and 3G/4G cellular networks, and videoconferencing software that promotes interoperability between disparate mobile platforms, such as Android and iOS, the authors wrote.

University of Michigan researchers recently unveiled a concussion-specific app called Return2Play to track injuries, symptoms and details important to recovery. A study published earlier this year in Journal of Clinical and Experimental Neuropsychology, however, questioned the use of computerized tests to evaluate concussion, finding that some tests don't measure functional and metabolic impairments of the brain

To learn more:
- read the research

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