Synchronous telemedicine (i.e., real-time telemedicine) is a virtual alternative to an in-person doctors visit: think FaceTime or Video chat between a patient and their provider or caregiver. Synchronous telemedicine has evolved and expanded in recent years, but two questions remain: one, are video visits cost-effective and two, can providers deliver quality care through video visits?
A recent prospective observational study out of Jefferson Health evaluated the financial impact of synchronous audio and video on demand telemedicine visits in episodic based cost of care. Researchers explored what patients would have done had telemedicine not been available and what the patients did following the telemedicine visit. The study evaluated 650 patients across eight months and determined that telemedicine is both cost-effective and able to resolve the majority of patients' health concerns. Of the 650 patients, 74% had their care concerns resolved on the telemedicine visit.
Notably, net cost savings to the payer or patient per visit ($49 flat fee) ranged from $19 - $121. Researchers determined net cost savings by combining the cost savings from diversion (between $57 and $238) and the weighted average post-call cost per visit (between $38 and $118). The cost savings achieved were generated by diverting patients away from the emergency department – the most expensive alternative care setting. Each emergency department visit that was avoided resulted in cost savings ranging from $309 to over $1,500.
When comparing the cost of a telemedicine video visit to that of an alternative care setting, the opportunity for cost saving is evident, especially for emergency department visits avoided. Cost assumptions as determined by Jefferson Health can be seen in the graph below:
Fig 1: On-demand synchronous audio video telemedicine visits are cost effective. The American Journal of Emergency Medicine,37(5), 890-894.
A recent study out of Kaiser Permanente in California surveyed patients with a scheduled video visit to evaluate patient experience through responses on several elements including convenience, quality, patient-provider relationship, and impact on in-person visits.
Researchers surveyed 1,274 patients who had a video visit over three months and discovered that patients found the encounter convenient and satisfying. 93% of the patients surveyed responded that the video adequately addressed their needs and 84% responded that being able to have a video visit improved their relationship with their provider. In an industry that is rapidly shifting towards value-based care achieving these results is essential.
Real-time telemedicine video visits improve access to quality care by reducing the barrier of transportation and time, facilitating communication between the provider and patient from anywhere. By diverting patients away from costly care settings, this format of patient-provider communication achieves significant cost savings while also maintaining a high standard of care.
As the healthcare industry continues to evolve, the practice of video visits will inevitably become commonplace. It is essential that providers and patients alike are equipped with the tools they need to make video visits a successful and effective care alternative.
References:
Nord, G., Rising, K. L., Band, R. A., Carr, B. G., & Hollander, J. E. (2019). On-demand synchronous audio video telemedicine visits are cost effective. The American Journal of Emergency Medicine,37(5), 890-894. doi:10.1016/j.ajem.2018.08.017
Reed, M. E., Huang, J., Parikh, R., Millman, A., Ballard, D. W., Barr, I., & Wargon, C. (2019, April 30). Patient–Provider Video Telemedicine Integrated With Clinical Care: Patient Experiences. Retrieved from https://annals.org/aim/article-abstract/2732082/patient-provider-video-telemedicine-integrated-clinical-care-patient-experiences