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Oral Presentation

(V5-01) Pediatric Inpatient Telemedicine with Critical Care and Specialty Consults- One Institution’s Look at Cost Savings

Monday, April 24
10:15 AM - 10:34 AM
Location: W230 BC

Previous research has demonstrated that pediatric telemedicine has been cost-savings when delivered in an emergency room setting (1). In our organization, we were determined to evaluate the cost savings, and potential payback period for an investment into telemedicine in an inpatient 42-bed unit. This investment included in-room systems in each of the 42 rooms including codecs with 12x zoom as well as several telemedicine carts and peripherals. The model of care was that unit was staffed by pediatric hospitalists and surgical APRNs 24/7. There is not a pediatric intensive care unit (PICU) on site, so patients requiring that level of care would need to be transferred to the main campus, over 20 miles away. Additionally, specialists in six identified anchor divisions would be on site daily from 8am-5pm for outpatient clinical and available for inpatient consultations. However, consultations in off hours or from some of our other over 30 specialties often is not available onsite. The telemedicine investment allowed for critical care participation in every rapid response team (RRT) and in every code. Additionally, consultation from any medical/surgical specialty can be requested by this inpatient unit, and if not available in person, can be performed via telemedicine. In the first year the unit was open we identified thirty-five cases where a patient had an RRT, was not transferred to PICU, and was able to remain in the inpatient unit. It was estimated that 90% of patients with RRT that were called would have been transferred to PICU if not for critical care consultation. This led to a cost saving estimated at of approximately $3000 per patient when cost of transport and difference of cost of 1 ICU bed day was compared with 1 non-ICU bed day. Additionally, our providers delivered 66 formal specialty consultations via telemedicine during that first year. The assumption was that if consulting provider was not available via telemedicine approximately 50% of those cases would have been transferred to facility where specialists was available for consultation. We also accounted for 50% of those where specialist would have traveled to see patient in person. Accounting for transfer cost savings, as well as savings from mileage and non-productive time if physicians traveled we assumed another approximately $55,000. The total cost savings to the organization in year one (with conservative estimates) was $154,500. The payback period is estimated to 3.45 years approximately with all cost savings included if utilization is assumed to be constant to year one with flat census. With anticipated growth, we anticipate payback period to be shorter.

Learning Objectives:

Jennifer G. Ruschman

Director of Telehealth
Cincinnati Children's Hospital Medical Center

Jennifer Gamm Ruschman is the Director of Telehealth at Cincinnati Children's Hospital. She received her Bachelor's Degree in Biology from Case Western Reserve University and her Master's Degree in Genetic Counseling from Johns Hopkins. She is a healthcare professional with a diverse background. She provided clinical genetic counseling services for several years before diversifying her expereicnes. Experiences include product/service development, project management, and relationship management. Her focus has been healthcare operations and Ms. Ruschman enjoys fields that require strong technical background. She helped to develop the Center for Telehealth at Cincinnati Children's Hospital Medical Center in 2013, and has served as the Director of that Center since its inception. Her team has developed over 50 different pediatric telehealth programs in inpatient, outpatient, and home settings.

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Kelsey Hofacer

Consultant, Center for Telehealth
Cincinnati Children's Hospital Medical Center

Kelsey joined the Center for Telehealth in 2014. She has been instrumental to the Center's success. Not only in program development and launch, but with her strong analytic skills. Prior to joining the Center for Telehealth, Kelsey had numerous roles in healthcare while pursuing her MHSA. Prior to that she worked as an auditor in the oil and gas industry.

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Kathy Kramer

Program Manager, Center for Telehealth
Cincinnati Children's Hospital Medical Center

Kathy is a Program Manager with the Center for Telehealth. She started working in telehealth in 2014, and is a major contributor to our program. She develops new programs, from concept through first year of execution. She has a background in healthcare, and has served Cincinnati Children's wonderfully for over 35 years.

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