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Telemedicine yielded reduced costs, high patient satisfaction in a sports medicine setting
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Use of telemedicine in a sports medicine setting may provide efficient care to patients, reduced costs and high levels of patient satisfaction, according to results.
Alfred Atanda Jr., MD, and colleagues compared time for clinical visits and wait times between patients younger than 18 years who had either a telemedicine visit or an in-person visit at a tertiary pediatric orthopedic center. Researchers calculated costs to patients and department, and a five-item satisfaction survey was completed by patients regarding their telemedicine experience.
Compared with in-patient visits, results showed patients who had a telemedicine visit had shorter visits and shorter wait times, greater percentages of time spent with the provider, lower labor costs and lower travel costs. Researchers found telemedicine visits saved families 85 miles of driving and $50 in costs per visit. Telemedicine visits also saved $24 per patient in labor cost. Overall, researchers noted more than 90% of patients who had a telemedicine visit were satisfied with the service.
“Telemedicine is predicted to become one of the most disruptive innovations in health care delivery and patient engagement. We do need to remember, however, that it is not meant to completely replace traditional in-person visits, but meant to augment and enhance how traditional clinical care is delivered,” Atanda told Healio.com/Orthopedics. “It may not be ideal for all patients and should be used to treat and evaluate patients only when deemed appropriate by the treating provider. It is a valuable tool that orthopedists can use to decrease costs and wait times with the care that they deliver, while maintaining high levels of satisfaction.” – by Casey Tingle
Disclosure s : The authors report no relevant financial disclosures.
Perspective
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Joshua D. Harris, MD
Health care has entered the value-based care generation, emphasizing cost savings and improved quality. In pediatric sports medicine, Atanda Jr. and co-authors demonstrated savings in travel, wait and visit times with high patient satisfaction via 120 telemedicine “visits.” There were zero “no-shows,” no missed complications and no conversions from telemedicine to in-person [visits]. Despite these advantages, there are several disadvantages that currently preclude widespread operational use.
Yes, patients may be highly satisfied, but what about physician satisfaction? Doctors are already leaving jobs because they are “treating computer screens, not patients.” The relentless frustrations of the lack of interoperability of information technology (IT) in health care (imaging, laboratory values) are further responsibilities placed on the physician: “saved costs on other non-physician personnel” (now the physician does everything). Obvious start-up cost, maintenance IT cost and lost revenue from misplaced time efficiency (actual billable office visits, surgeries) may be financially troublesome. How is the physician given credit (wRVU collections)? Despite claims of security, it is impossible to fully ensure patient (and physician) privacy. Additionally, physical exam omission (liability) may induce greater unnecessary advanced imaging utilization (even higher costs).
Greater evidence is needed with patient and physician satisfaction measured, improved quality, decreased costs and optimized value before telemedicine can be successful in daily musculoskeletal medicine.
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