Remote epilepsy clinic using a video conferencing system

Abstract

Careful medical interviewing is crucial for the diagnosis of epilepsy. However, the number of available epilep-tologists is not adequate to serve the cities in Japanese regional areas. This study assessed the use of a videoconferencing system to hold a remote epilepsy clinic with the cooperation of a tertiary epilepsy center and a local public hospital in an area devastated by the Great East-Japan Earthquake and tsunami. The video-conferencing system established protocols to ensure the protection of personal information on the internet. Epileptologists in Tohoku University Hospital (tertiary epilepsy center) interviewed outpatients in the Kesennuma City Hospital (local public hospital) via the video-conferencing system. Medications and physical examinations were performed at the Kesennuma City Hospital based on the recommendations of the epileptologists. Nine patients received consultations via the remote epilepsy clinic from March 2012 to February 2013. Treatment strategies were established in 4 patients with epilepsy. Differential diagnosis was established in the other 5 patients with episodes of loss of consciousness. The interviews were successfully performed with the same quality as face-to-face interviews. Such remote clinics using the video-conferencing system will be valuable for medical support and education in medically underserved areas. However, the current health insurance system does not cover the provision of such telemedicine services in Japan.