Teleneuropsychology practice survey during COVID-19 within the United States

Abstract

Objective

Identify factors influencing service delivery changes during COVID-19 and examine barriers and provider satisfaction with teleneuropsychology (teleNP).

Method

Licensed clinical neuropsychologists within the United States recruited via neuropsychology-specific listservs (July–August 2020) to complete an online survey.

Results

A total of 261 individuals completed the survey. Most (76%) reported delivering in-person testing in some capacity at the time of our survey. Relatively more private practitioners identified concerns with privacy/confidentiality (45.2% vs. 17.9%; χ²(2) = 6.99, p < 0.05), legal issues (47.6% vs. 17.9%; χ²(2) = 8.06, p < 0.05), and an undesirable precedent for legal/forensic cases (59.5% vs. 15.4%; χ²(2) = 17.54, p < 0.001) compared to hospital or other medical (non-VA) practitioners. Multiple resources informed teleNP protocols, such as organization guidelines (87.6%), literature review (75.9%), webinars (72.4%), and consultation (68%). Several factors influenced test selection, including availability of normative data (70.1%), test familiarity (66.4%), administration time (63.5%), and evidence base (60.6%). Reported barriers to continuing teleNP after COVID-19 included need for improved teleNP norms (85.9%), domain coverage (84.7%), improved patient access to technology (74.1%) and further validation studies (84.1%).

Conclusion

TeleNP may not be feasible in all settings and/or referrals. Respondents employed multiple resources in aggregating teleNP protocols and considered several factors when selecting tests. Results highlight the complex and varied decision-making processes utilized by respondents to adapt to service delivery changes. Considering the many benefits of teleNP, future research addressing some of the potentially modifiable factors (e.g., technology access, attitudes regarding teleNP) and significant development needs for teleNP itself (i.e., improved teleNP norms, further validation studies, etc.) is warranted.

Keywords:

• COVID-19
• service delivery
• survey
• telehealth
• teleneuropsychology

Acknowledgments

The authors would like to thank the neuropsychologists who took the time to complete the survey.

Disclosure statement

The authors do not have any conflicts of interest to disclose.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data is not available.