Telemedicine, Mobile, and Internet-Based Neurocognitive Assessment

Abstract

A new medium for delivering neuropsychological assessments has emerged as a result of the Internet called teleneuropsychology. This chapter reviews teleneuropsychology’s potential for extending the availability of neuropsychological assessments to remote and geographically isolated areas. Within the teleneuropsychology framework, neuropsychologists use video teleconferencing, smartphones, and Web-based assessment to administer, score, and aide interpretation of neuropsychological assessments. The chapter includes a discussion of studies comparing video teleconferencing to in-person assessments. Preliminary evaluation of patient acceptance of this methodology has revealed that teleneuropsychology appears to be well accepted by consumers. While teleneuropsychology offers a great deal of promise for remote assessment in general, there are strengths and weaknesses for various modalities and approaches that need to be discussed. For example, while teleconferencing allows neuropsychologists to connect with patients in remote areas, it falls far short of the stimulus presentation and logging found in computer-automated assessments. These limitations and the lack of ecological validity of assessments are discussed. While teleneuropsychology needs to move beyond video-teleconferenced administration of paper-and-pencil tasks, there are possibilities for enhancing data collection and database building for personalized medicine. Given the vast reaches of the Internet, future iterations of teleneuropsychological applications that embrace the technological advances of computerized administration (including simulated environments) have potential for enhanced stimulus presentation, data logging, and ecological validity.

Another possibility for increasing throughput is to adopt less labor-intensive procedures for example, it is possible to collect information of certain behavioral features through assessment tools that can be self-administered over the Internet by individuals throughout the world.

—Freimer and Sabatti (2003)