Garrison Nord1, Kristin L Rising1, Roger A Band1, Brendan G Carr1, Judd E Hollander2. 1. Department of Emergency Medicine, Department of Emergency Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA. 2. Department of Emergency Medicine, Department of Emergency Medicine, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA. Electronic address: Judd.hollander@jefferson.edu.
Abstract
INTRODUCTION: Claims data raises the possibility that on demand telemedicine programs might increase new utilization, offsetting the cost benefits described in some retrospective analyses. We prospectively evaluated the cost of a synchronous audio-video on-demand telemedicine taking into account both what patients would have done instead of the telemedicine visit as well as the care patients received after the visit. MATERIALS AND METHODS: We conducted a prospective observational study of patients who received care from an on-demand telemedicine program. At the time of the visit, we surveyed patients about the alternative care that would have been requested, if they had not done the telemedicine visit. We also obtained information following the visit about what further care was received. Using cost data derived from the literature we performed a sensitivity analysis to determine the cost impact of the on-demand telemedicine visit. RESULTS: There were 650 patients enrolled with a mean age of 37 who were 68% female; 74% had their care concerns resolved on the telemedicine visit; only 16% would have "done nothing" if they had not done the telemedicine visit, representing possible new utilization. Net cost savings per telemedicine visit was calculated to range from $19-$121 per visit. CONCLUSIONS: In our on-demand telemedicine program, we found the majority of health concerns could be resolved in a single consultation and new utilization was infrequent. Synchronous audio-video telemedicine consults resulted in short-term cost savings by diverting patients from more expensive care settings.
INTRODUCTION: Claims data raises the possibility that on demand telemedicine programs might increase new utilization, offsetting the cost benefits described in some retrospective analyses. We prospectively evaluated the cost of a synchronous audio-video on-demand telemedicine taking into account both what patients would have done instead of the telemedicine visit as well as the care patients received after the visit. MATERIALS AND METHODS: We conducted a prospective observational study of patients who received care from an on-demand telemedicine program. At the time of the visit, we surveyed patients about the alternative care that would have been requested, if they had not done the telemedicine visit. We also obtained information following the visit about what further care was received. Using cost data derived from the literature we performed a sensitivity analysis to determine the cost impact of the on-demand telemedicine visit. RESULTS: There were 650 patients enrolled with a mean age of 37 who were 68% female; 74% had their care concerns resolved on the telemedicine visit; only 16% would have "done nothing" if they had not done the telemedicine visit, representing possible new utilization. Net cost savings per telemedicine visit was calculated to range from $19-$121 per visit. CONCLUSIONS: In our on-demand telemedicine program, we found the majority of health concerns could be resolved in a single consultation and new utilization was infrequent. Synchronous audio-video telemedicine consults resulted in short-term cost savings by diverting patients from more expensive care settings.
Authors: Claudia Der-Martirosian; Karen Chu; W Neil Steers; Tamar Wyte-Lake; Michelle D Balut; Aram Dobalian; Leonie Heyworth; Neil M Paige; Lucinda Leung Journal: BMC Prim Care Date: 2022-06-18
Authors: Jedrek Wosik; Megan E B Clowse; Robert Overton; Bhargav Adagarla; Nicoleta Economou-Zavlanos; Joanna Cavalier; Ricardo Henao; Jonathan P Piccini; Laine Thomas; Michael J Pencina; Neha J Pagidipati Journal: Am Heart J Date: 2020-11-01 Impact factor: 4.749
Authors: Jacqueline M Ferguson; Josephine Jacobs; Maria Yefimova; Liberty Greene; Leonie Heyworth; Donna M Zulman Journal: J Am Med Inform Assoc Date: 2021-03-01 Impact factor: 4.497
Authors: Ashwin Ramaswamy; Miko Yu; Siri Drangsholt; Eric Ng; Patrick J Culligan; Peter N Schlegel; Jim C Hu Journal: J Med Internet Res Date: 2020-09-09 Impact factor: 5.428