CommentaryTelemedicine in Behavioral Neurology–Neuropsychiatry: Opportunities and Challenges Catalyzed by COVID-19Perez, David L. MD, MMSc*,†; Biffi, Alessandro MD*,†; Camprodon, Joan A. MD, PhD, MPH*,†; Caplan, David N. MD, PhD*; Chemali, Zeina MD, MPH*,†; Kritzer, Michael D. MD, PhD*,†; Moo, Lauren R. MD*,‡; Newhouse, Amy L. MD†; Ramirez-Gomez, Liliana MD*; Razafsha, Mahdi MD*,†; Tanev, Kaloyan S. MD, MPH†; Schmahmann, Jeremy D. MD*,§ Author Information *Cognitive Behavioral Neurology Unit, Department of Neurology †Division of Neuropsychiatry, Department of Psychiatry §Ataxia Center, Laboratory for Neuroanatomy and Cerebellar Neurobiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts ‡Geriatric Research Education and Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts J.A.C. is a scientific advisor for Apex Neuroscience. The remaining authors declare no conflicts of interest. Correspondence: David L. Perez, MD, MMSc, Departments of Neurology and Psychiatry, Massachusetts General Hospital, 55 Fruit Street, Boston, Massachusetts 02114 (email: [email protected]). Cognitive and Behavioral Neurology: September 2020 - Volume 33 - Issue 3 - p 226-229 doi: 10.1097/WNN.0000000000000239 Buy Metrics Abstract Coronavirus 2019 (COVID-19) has profoundly impacted the well-being of society and the practice of medicine across health care systems worldwide. As with many other subspecialties, the clinical paradigm in behavioral neurology and neuropsychiatry (BN–NP) was transformed abruptly, transitioning to real-time telemedicine for the assessment and management of the vast majorities of patient populations served by our subspecialty. In this commentary, we outline themes from the BN–NP perspective that reflect the emerging lessons we learned using telemedicine during the COVID-19 pandemic. Positive developments include the ability to extend consultations and management to patients in our high-demand field, maintenance of continuity of care, enhanced ecological validity, greater access to a variety of well-reimbursed telemedicine options (telephone and video) that help bridge the digital divide, and educational and research opportunities. Challenges include the need to adapt the mental state examination to the telemedicine environment, the ability to perform detailed motor neurologic examinations in patients where motor features are important diagnostic considerations, appreciating nonverbal cues, managing acute safety and behavioral concerns in less controlled environments, and navigating intervention-based (neuromodulation) clinics requiring in-person contact. We hope that our reflections help to catalyze discussions that should take place within the Society for Behavioral and Cognitive Neurology, the American Neuropsychiatric Association, and allied organizations regarding how to optimize real-time telemedicine practices for our subspecialty now and into the future. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.