Jessica Fesler, MD: Barriers to Adopting Telemedicine


Despite showing great promise to provide additional and supplementary care to patients with a number of conditions, including epilepsy, some barriers remain to bringing telemedicine to more providers and patients.

“We’re doing [patients] a disservice if we don’t leverage technology to take better care of them. There are a lot of downsides to technology, but this is one upside that we can really leverage to help people.”

Jessica Fesler, MD, staff epileptologist, Cleveland Clinic Epilepsy Center, and colleagues presented a large, single-center dataset showing the success and feasibility of telemedicine in epilepsy at the 73rd annual meeting of the American Epilepsy Society (AES), December 6-10, 2019, in Baltimore, Maryland.

Their data suggest that the practice not only offers a number of advantages to patients and providers, including cost savings, convenience, time savings, etc., but that it is a feasible one for widespread use in epilepsy.1 A number of other studies have suggested similar results across the breadth of neurology.2,3 However, there are barriers that remain in bringing this to more physicians and hospital systems—most notably, reimbursement.

To find out more about what challenges this innovation in medicine is facing and how the physician community is overcoming it, at least in epilepsy care, NeurologyLive sat with Fesler to discuss her experience in using the program at Cleveland Clinic over the last several years.

For more coverage of AES 2019, click here.


1. Fesler JR, Stanton S, Merner K. Bridging the Gap in Epilepsy Care: A Single-Center Experience of More Than 1000 Tele-Epilepsy Visits. Presented at: AES 2019; December 6—10; Baltimore, Maryland. Abstract 2.36.

2. Hatcher-Martin JM, Adams JL, Anderson ER, et al. Telemedicine in neurology: Telemedicine work group of the American Academy of Neurology update. Neurology. 2020;94:1-9. doi:10.12.12/WNL. 0000000000008708.

3. Guzik AK, Switzer JA. Teleneurology is neurology. Neurology. 2020;94:1-2. doi:10.1212/WNL.0000000000008693.

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