Cost–benefit analysis of telehealth in pre-hospital care

Abstract

Objective There has been very little use of telehealth in pre-hospital emergency medical services (EMS), yet the potential exists for this technology to transform the current delivery model. In this study, we explore the costs and benefits of one large telehealth EMS initiative. Methods Using a case-control study design and both micro- and gross-costing data from the Houston Fire Department EMS electronic patient care record system, we conducted a cost-benefit analysis (CBA) comparing costs with potential savings associated with patients treated through a telehealth-enabled intervention. The intervention consisted of telehealth-based consultation between the 911 patient and an EMS physician, to evaluate and triage the necessity for patient transport to a hospital emergency department (ED). Patients with non-urgent, primary care-related conditions were then scheduled and transported by alternative means to an affiliated primary care clinic. We measured CBA as both total cost savings and cost per ED visit averted, in US Dollars ($USD). Results In total, 5570 patients were treated over the first full 12 months with a telehealth-enabled care model. We found a 6.7% absolute reduction in potentially medically unnecessary ED visits, and a 44-minute reduction in total ambulance back-in-service times. The average cost for a telehealth patient was $167, which was a statistically significantly $103 less than the control group ( p < .0001). The programme produced a $928,000 annual cost savings from the societal perspective, or $2468 cost savings per ED visit averted (benefit). Conclusion Patient care enabled by telehealth in a pre-hospital environment, is a more cost effective alternative compared to the traditional EMS 'treat and transport to ED' model.

Interfacility neurosurgical transfers: an analysis of nontraumatic inpatient and emergency department transfers with implications for improvements in care

“…Telemedicine has also been cited as a potential means to improve communication between providers to ensure that an appropriate level of care is initiated at the accepting facility. 6,9,20 Such devices would allow direct visualization as an outside provider performs a bedside examination of a patient and review of appropriate imaging. Future studies should aim to develop algorithms that can recognize which patients do not require emergency transfer and determine the utility of telemedicine consults to ease the burden and cost of traditional transfers.…”

A Cost-Minimization Analysis of a Medical Record-based, Store and Forward and Provider-to-provider Telemedicine Compared to Usual Care in Catalonia: More Agile and Efficient, Especially for Users

“…Telemedicine nowadays coexists alongside conventional healthcare in most healthcare systems [1]. Although systematic reviews of its economic impact suggest that, for the time being, it is not suited to widespread implementation in all specialties and contexts [2,3], recent studies suggest that it is cost-effective in fields such as emergency medicine, cardiology, the management of diabetes and ophthalmology [4][5][6][7][8][9][10][11].…”

Telenotarzt

“…Die genannten Faktoren begünstigen ferner, dass zunehmend mehr Patienten die Notaufnahmen der Krankenhäuser selbst oder über die Inanspruchnahme des Rettungsdienstes aufsuchen [21]. Eine Entlastung der Notaufnahmen ist potenziell möglich, wenn weniger Patiententransporte stattfinden, weil Rettungsdienstpersonal vor Ort durch Konsultation des Telenotarztes mehr Optionen hat, den Patienten beispielsweise an eine geeignetere Einrichtung als die Notaufnahme eines Krankenhauses verweisen zu können [12,14].…”