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