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Posted December 20, 2007
Patient Safety and Quality Healthcare: News
Provider-to-Provider Telehealth Technolgies Will Save $4.28 Billion Annually
Robust nationwide telehealth systems remove barriers to care and improve quality in four healthcare settings.
Boston, MA, November 12, 2007 — The Center for Information Technology Leadership (CITL), a nonprofit research center based at Partners HealthCare System in Boston, has announced the publication of its research findings on the benefits and costs of provider-to-provider telehealth technologies. Telehealth, the use of communications technology to transmit medical information from one location to another, allows patients to receive care when and where it is needed, removing geography as a barrier to care. Funded by grants from the AT&T Center for Telehealth Research and Policy at the University of Texas Medical Branch at Galveston, the O'Donnell Foundation, AT&T Foundation, and the Harris and Eliza Kempner Fund, the landmark study's findings conclude that robust telehealth systems — nationally implemented with a five-year roll-out in emergency departments, correctional institutions, nursing homes, and physician offices — can save $4.28 billion annually.
CITL examined the overall value of three telehealth technology systems — — store-and-forward, real-time video, and a hybrid model that combines the first two — — in four different healthcare settings: emergency departments, correctional institutions, nursing homes, and physician offices. The report illustrates how these technologies can improve access-to-care issues for medically underserved geographic areas and under-represented medical specialties, and how the benefits far outweigh the costs to implement these systems. CITL projects the robust hybrid model to be the most cost-effective system of the three. By reducing face-to-face visits and redundant and unnecessary tests alone, the hybto implement these systems. CITL projects the robust hybrid model to be the most cost-effective system of the three. By reducing face-to-face visits and redundant and unnecessary tests alone, the hybrid system can save $3.61 billion annually. With a five-year roll-out nationwide, implementation of hybrid telehealth technologies reaches a break-even point in year five, with a total annual net savings in the steady-state of $4.28 billion.
The full report, The Value of Provider-to-Provider Telehealth Technologies, is available for download on CITL's website (www.citl.org), and a soft-bound copy is available from the Healthcare Information and Management Systems Society (www.himss.org). Key findings were presented at the national conference on the business of telemedicine in Galveston, Texas, which is sponsored by the AT&T Center for Telehealth Research and Policy at the University of Texas Medical Branch at Galveston (UTMB) and the Electronic Health Network (EHN) of the UTMB. "Our research findings have significant implications regarding how we can improve the delivery of healthcare in the future," says Caitlin M. Cusack, MD, MPH, CITL senior analyst, and the report's lead author. "The current system, where primary care physicians manage as much of a patient's care as possible, with specialists seen as a last resort, does not seem to be the most effective approach to care. A collaborative model, with a primary care and specialist team involved early with a patient's care, has the potential to lead to significant cost savings."
In its report, CITL examined the cost-benefit of telehealth technologies with providers involved in varying levels of patient encounters:
- Store-and-forward technologies represent the collection and storage of clinical data or images that are forwarded for interpretation at a time that occurs later than a face-to-face clinical encounter. For example: A primary care physician takes digital images of a patient's rash and forwards them to a dermatologist. The dermatologist reviews the images and advises the physician on the care of the rash. This review may take place immediately, or hours or days later.
- Real-time video is the use of live video to conduct an interactive clinical encounter in real time. For example: A prisoner in a correctional facility with complex heart disease has regularly scheduled "visits" with a cardiologist located hundreds of miles a way. The cardiologist "sees" the patient via the use of live video. The video allows the patient to "see" the physician as well. The cardiologist is able to ask questions of the patient in real time to help guide the medical assessment.
- Hybrid technology integrates both store-and-forward and real-time video technologies. As in the store-and-forward case, a primary care physician takes digital photos of a patient's rash. These photos are forwarded to a dermatologist for review. A "visit" is scheduled with the dermatologist located hundreds of miles away. A live video is used during this "visit" so the dermatologist may speak with the patient, gather a history of the condition, and examine the rash not only on the digital photos, but via the video camera as well. This combined technology represents a robust system, which results in increased benefits that neither store-and-forward nor real-time video can realize alone.
In its report, CITL found that the benefits far outweigh the costs of implementing these telehealth systems, and it recommends the hybrid system as the best investment for telehealth programs located in emergency departments, correctional institutions, nursing homes, and physician offices.
- There are 2.2 million patients transported between emergency departments each year at a cost of $1.39 billion. Telehealth technologies would reduce these transports by 850,000, saving $537 million a year.
- There are 94,180 transports made annually from correctional facilities to emergency departments at a cost of $158 million in transportation and visit costs. The use of telehealth technologies could avoid 40,000 of these transports, saving $60.3 million a year.
- There are 691,000 physician office visits made by prisoners each year, costing $302 million. The use of telehealth technologies could avoid 543,000 inmate transports, saving $210 million a year.
- There are 2.7 million transports made annually from nursing facilities to emergency departments at a cost of $3.62 billion in transportation and visit costs. The use of telehealth technologies could avoid 387,000 of these transports, saving $327 million a year.
- There are 10.1 million physician office visits made annually from nursing home facilities at a cost of $1.29 billion. Telehealth technologies could avoid 6.87 million transports, saving $479 million a year.
The Center for Connected Health, a division of Partners HealthCare and a leader in the use of technology to deliver quality care outside of the hospital or doctor's office, provided research assistance for the report.
"Telehealth technology has enormous opportunity to increase quality while lowering the overall cost of care," says Joseph C. Kvedar, MD, Director, Center for Connected Health and member of CITL's Advisory Board. "As the fees for face-to-face provider services continue to increase, the cost-benefit picture of telehealth improves — — while bringing care to patients where they are and when they need it."
Chartered in 2002 by Boston-based, nonprofit Partners HealthCare System, CITL assesses the value that information technology (IT) brings to healthcare. Using a rigorous approach, CITL performs research, disseminates findings, and provides additional services designed to help healthcare providers and other stakeholders improve quality and reduce cost using IT. For more information, visit www.citl.org.
The AT&T Center for Telehealth Research and Policy at UTMB at Galveston, the only center devoted to the scientific study of telemedicine and the development of telehealth policy in the United States, was founded in 2002 with a grant from the SBC Foundation (now the AT&T Foundation) (www.attcenter.utmb.edu). The Electronic Health Network (EHN) at UTMB was created in 2004 to centralize all of UTMB's skills, competencies, and technical resources into one entity. The EHN is charged with operating, analyzing, and making available to others the systems and programs that prove effective in the area of telehealth and telemedicine (www.telemedicine.utmb.edu).
HIMSS provides leadership in healthcare for the advancement and management of information technology and management systems (www.himss.org).
A division of Partners HealthCare and a leader in the use of technology to deliver quality care outside of the hospital or doctor's office. The organization is developing initiatives in telehealth, remote care, and disease and lifestyle management programs to better manage and monitor patient health, offer expert second opinions and provide convenient, personalized medical care. Using consumer technologies and online resources such as the Internet, cell phones, digital cameras, and sensors, the Center for Connected Health is helping to connect leading medical specialists with patients — — in their homes, offices, and around the world (www.connected-health.org).
The ATA is the leading international resource and advocate for telemedicine, promoting access to medical care for consumers and providers via telecommunications technology (www.americantelemed.org).
Partners HealthCare, located in Boston, is an integrated health system founded by Brigham and Women's Hospital and Massachusetts General Hospital. In addition to its two academic medical centers, the Partners HealthCare System also includes community and specialty hospitals, community health centers, a physician network, home health and long-term care services, and other health-related entities. Partners HealthCare is one of the nation's leading biomedical research organizations and a principal teaching affiliate of Harvard Medical School. Partners HealthCare is a non-profit organization.
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