Saving Health Care Dollars While Improving Efficiency and Outcomes

Maggie Gilligan, RD, CSG, LDN

Here is some insight into our health care future. This work demonstrates how we may save health care dollars, while improving efficiency and health care outcomes.

Because of the high incidence of unnecessary transfers of nursing home residents to the emergency department, a telemedicine program, which included 10 nursing homes in five rural communities, was set up to perform emergency telemedicine consults.

When a patient had symptoms that warranted the possible transfer to an emergency room, the nurse would fax or call in the patient’s demographics and a doctor trained in emergency medicine would evaluate the patient in the nursing home using a telemedicine system. The doctor could not only speak to the nurse and patient, but also could look into the ears, listen to the chest, and view the skin with a magnifying glass.

According to the study, early results suggest the program has meaningfully reduced the need for emergency department (ER) transfers. During the first year of operation, 20 telemedicine consults took place. Ten of those consults resulted in not having to transfer the patient. Prior to this program, all of these patients would have had an emergency department transfer.

Based on this small study, it would decrease half of the transfers of nursing home patients to the ER, allowing the department to focus on patients with true emergencies. This also decreases the cost of health care over time. Cost of the telemedicine unit is about $20,000. Approximate cost to transfer to ER is $1000, with a cost of approximately $500 for minor treatment. This improves the value equation, because this method is usable across many different areas of the country, from urban areas to rural communities. Regardless of socioeconomic status, people do not want to go to the emergency room unless it is absolutely necessary.

References

Janiak B. Telemedicine in the emergency department. Available at: http://www.slideshare.net/gatelehealth/telemedicine-in-the-emergency-dept. Accessed August 23, 2012.

US Dept of Health and Human Services, Agency for Healthcare Research and Quality. Telemedicine consultations with emergency department physicians reduce unnecessary transfers of nursing home residents in rural areas. Available at: http://www.innovations.ahrq.gov/content.aspx?id=3189 . Accessed August 23, 2012.