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Quantifying the value of pediatric telemedicine in rural communities

por John W. Mitchell, Senior Correspondent | May 29, 2015
How valuable can remote consultation be to the care of pediatric patients? A study conducted by UC Davis and published in the journal Medical Decision Making has put a price tag on the outcomes achieved at a rural hospital using telemedicine for pediatric critical care examinations.

“We’ve been doing telemedicine consultation for some time at the bedside to help seriously ill children,” Dr. James Marcin, chief of pediatric critical care medicine at UC Davis, told DOTmed News.

He describes telemedicine consultations as being good for everyone involved. "They help keep kids — who don’t need the stress of being transferred — in their local hospital and community, while greatly reducing transport costs for the parents," says Marcin.
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Marcin said that it’s not unusual for a child transferred to UC Davis, (a Level I pediatric trauma center) by air or ground to be ready for discharge before the parents have even arrived at the hospital. In the case of a helicopter medevac, costs can easily exceed $10,000.

The new research has shown telemedicine consultations can reduce pediatric transfers by 31 percent. Conversely, Marcin said, connecting remotely helps identify children who have conditions serious enough to warrant transfer to an even higher-level care facility.

“About every week or two, we get a call about a kid in a rural ER who the doctor is thinking about transferring. We take a look through the telemedicine portal and the kiddo looks fine," said Marcin. "This is very reassuring to the emergency department physician and the parents. This is a low-cost way to partially address a lack of pediatric specialty care in rural locations.”

While there are costs associated with installing a telemedicine system, the study found that consults conducted through them produced an average savings of roughly $3,641 per case. When potential transports costs are included, the savings average rises to $4,662 – and this does not take into account direct costs to the parents, such as gas, meals and hotels.

The study was conducted at eight rural hospitals between 2003-2009. It partnered health care economists and physicians to conduct the research. For Marcin, although the cost savings were not very surprising, the results are timely, given the Affordable Care Act's value-based goals

“In California, doctors get paid for telemed consults, but in many states they don’t,” said Marcin. “The study indicates that telemed should be adopted more widely in health care to help control costs.”

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