Clinical Services

Oral Presentation

(CS6-02) Benefits of a Neuro-Emergent Telemedicine Consultation Program

Monday, April 24
12:00 PM - 12:30 PM
Location: W224 AB

Objectives
• Present potential benefits of neurological telecare.
• Describe short fallings of current knowledge.
• Determine patient cost savings and health outcomes.
• Explain potential gains to rural area hospitals.


Methods
A Markov Decision Tree model is used by taking existing literature for patient outcomes, the likelihood of receiving rtPA, the probability of different strokes, different costs of care and resulting QALYs. Likelihood of receiving rtPA and patient transfer were taken from preliminary findings from the Access program for emergency room patients in rural New Mexico from May 2015 to August 2016. We estimate the outcomes and costs of 1000 patients who are taken to a treatment hospital that has neurological telecare and 1000 patients who are not. We calculated the chance of being transferred changing from 85% to 10% and the chance of getting scanned within 4.5 hrs from 2% to 19.47%. These numbers come from the preliminary findings and calculations.

Results
The results indicate that use of neurological telecare could result in cost savings of $17,463 per patient. The model estimates an increase of 0.1 QALY of survival per patient treated at a hospital with Neurological telecare. For every 100 patients treated this way there is a gain of 10 QALYs and patient cost reduction of $1,746,300. The model also shows that the rural hospitals would get to keep patients that did not need to be transferred for a gain to the rural hospital of $3,400,000 per 100 patients.

Conclusion
This preliminary analysis demonstrates significant savings and improved quality of life associated with the use of neurological telecare for patients and allows rural hospitals to keep patients that would otherwise be transferred.

Justin S. Whetteh

Research Assistant
University of New Mexico

Justin Whetten is a PhD candidate in development Economics at the Univeristy of New Mexico. He is currently working as a research assistant on the ACCESS project, looking at health benefits and cost savings of Neurological Telemedicine. Justin has worked as an analyst for New Mexico Human Services and has over 5 years experience in medical laboratory testing environment. His current research interests are health and education for developing countries and rural America.

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Colin Semper

Administrator
University of New Mexico Department of Neurosurgery

Colin Semper is the Administrator of the Department of Neurosurgery at the University of New Mexico.

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Howard Yonas

Professor and Chair
University of New Mexico Department of Neurosurgery

Dr. Yonas obtained his medical degree from Ohio State University. He completed internship and residency in Neurosurgery at Case Western Reserve University. As the director of the new UNM Cerebrovascular Center, Dr. Yonas is working to build a strong interdisciplinary stroke team which will focus an innovative combination of invasive and non-invasive technologies designed to improve stroke and trauma care.

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Maurice L. Moffett

Research Assistant Professor
University of New Mexico Health Sciences Center

Maurice "Mark" Moffett is a Research Assistant Professor in the Department of Family and Community Medicine in the Office for Community Health. Dr. Moffett earned his PhD in Economics at the University of New Mexico and received postdoctoral training in Health Services Research (HSR) through the VA HSR&D and the Baylor College of Medicine. His expertise include economic evaluation, outcomes research, comparative effectiveness and health workforce analysis.

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