Telemedicine could eradicate many expensive ED visitsMay 06, 2008More than 25 percent of pediatric "emergency" visits could be conducted online A community-wide study in upstate New York found that nearly 28 percent of all visits to the pediatric emergency department could have been replaced with a more cost-effective Internet doctor's "visit," or telemedicine, according to investigators from the University of Rochester Medical Center. The Rochester team will present these findings and more at this year's Pediatric Academic Society Meeting, to be held Friday, May 2 through Tuesday, May 6, in Honolulu, Hawaii. "We learned that more than one in four local patients are using the pediatric emergency department for non-emergencies," said Kenneth McConnochie, M.D., M.P.H., the study's lead investigator and a professor of Pediatrics at the University of Rochester's Golisano Children's Hospital at Strong. "This mismatch of needs and resources is inefficient, costly and impersonal for everyone involved." McConnochie and colleagues - who direct Health-e-Access, a Rochester-based telemedicine program that provides interactive, Internet-based health care "visits" to diagnose and treat routine childhood symptoms in 19 urban and suburban schools and childcare centers - analyzed data from 2006, tracking all pediatric (younger than 19) visits to the largest emergency department in the city. Given experience with over 6,000 successfully-managed telemedicine visits that illustrate the extent of technology's capabilities, unique diagnoses from more than 22,000 pediatric ED visits were coded into various categories - first, ailments that virtually always prove manageable by telemedicine, such as ear infections or sore throats; second problems that are usually treatable through telemedicine, but not always, such as asthma attacks; and finally, conditions that were usually beyond the scope of the technology. Nearly 28 percent of ED visits fell into that first category; had these same problems been handled by telemedicine, this community would have had at least 12,000 fewer ED visits that year. "This would've not only freed up emergency resources to people who needed them more - it would have afforded smaller co-pays for parents and more timely, personalized care," McConnochie said. (On average, 87 percent of these telemedicine visits are handled by the child's own family pediatrician.) But parents aren't the only ones who stand to benefit. McConnochie, in related research also being presented at the upcoming meeting, suggests that telemedicine will also serve the ultimate objectives of insurers and the community as well - better quality care at a lower price. Typically, insurers have been wary of embracing the technology, fearing the convenience may lead parents to use medical care more often and drive up costs; but another community study from Rochester suggests the exact opposite - that in the long run, insurers actually would realize cost savings - more than $14 per child per year in that local community. In that study, researchers analyzed two groups of children that were almost identical - except one had access to their doctor's office, the emergency department, and telemedicine technology for care, and the second had only the first two options. They tracked how often families used services, and which ones. "We found that the first group of families, which had access to telemedicine for their children, did in fact access care for illness overall nearly 23 percent more often than the second group," McConnochie said. But since emergency department visits among these children with telemedicine access were nearly 24 percent less common - and since these visits cost about 7-times the cost of a doctor office or telemedicine visit - the telemedicine group ultimately still cost the insurers less per child over the course of a year. "It's similar to the idea of staying trim by eating healthy. It would be wrong to assume that someone who ate 20 items of food each day - all lean and nutritious - would be less healthy than someone who ate only 12 items - all high-fat, high-calorie, like donuts and fries," he said. "You can see how the logic of only counting food items (or total visits) falls apart. Clearly cost, as well as frequency, plays a role, whether the 'cost' of each unit is measured in calories or dollars." University of Rochester Medical Center |
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| Related Telemedicine Current Events and Telemedicine News Articles Pre-hospital organization: The first links in the chain of survival for heart attack patients Mortality rate following a heart attack has fallen by more than 50% in Europe over the past 25 years. However, because only minor advances in the medical treatment of AMI are expected over the next decade, it is through organisational changes in the pre-hospital phase that mortality rate will continue this decline to below 5%. Internet complicates doctor-patient relationships Patients who ask their doctor about information they have read on the Internet, or webs that better inform them of their diagnosis, are no longer a rarity. Retinopathy of prematurity diagnosis time significantly reduced using telemedicine To be properly diagnosed, retinopathy of prematurity (ROP), the leading cause of childhood blindness in the United States and worldwide, requires a time intensive process and significant coordination between ophthalmologist and NICU staff. Nationwide telemedicine networks are essential for successful health care reform The U.S. healthcare system is in critical need of basic change to enable more equitable, effective, efficient care. Experts in various fields of medicine, public health, and industry propose that telemedicine, or information technology enhanced healthcare, must be a core component of a viable healthcare reform strategy. Telemedicine Expands Reach of Care for Parkinson's Patients A unique and innovative telemedicine project is providing distant nursing home patients with Parkinson's disease access to neurologists at the University of Rochester Medical Center (URMC). Novel biomarkers in heart failure Several new biomarkers have been recently described in Heart Failure (HF) syndrome either in stable chronic patients as in the settings of acute decompensation. Telemedicine may improve care for school children with diabetes Type 1 diabetes is the most common chronic childhood disease. The management of this serious medical condition includes regular fingerstick glucose measurements, multiple daily injections of insulin, and frequent insulin dose adjustments. NASA's electronic nose may provide neurosurgeons with a new weapon against brain cancer An unlikely multidisciplinary scientific collaboration has discovered that an electronic nose developed for air quality monitoring on Space Shuttle Endeavour can also be used to detect odour differences in normal and cancerous brain cells. Telehealth for diabetes promotes aging at home, not in the hospital A large study of ethnically and racially diverse individuals with diabetes has found that home telemonitoring of their health resulted in significantly fewer deaths than in a similar group that was not monitored. Diabetes is the sixth leading cause of death in the United States. Telemedicine can dramatically improve child sexual assault examinations in rural areas The use of telemedicine can dramatically improve the quality of child sexual assault examinations in rural communities where rates of abuse and neglect are highest - sometimes more than double the statewide rate - a study published in the January issue of the medical journal Pediatrics has found. More Telemedicine Current Events and Telemedicine News Articles |
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