Value (Business Strategy and Financial Management)

ePoster Presentations

EP-152 - Cost-Utility of a Neuro-Emergent Telemedicine Consultation Program

Monday, April 30
4:05 PM - 4:20 PM
Location: Education Zone, Booth 2416, Screen 4

Objective: Evaluate from the cost-utility of a Neuro-Emergent telemedicine consultation program in the management of acute ischemic stroke.
Methods: A Markov model was developed for both 90-day and lifetime horizons. Costs were gathered using a societal perspective and include initial and recurrent stroke treatments, consultations, patient transports, rehabilitation, long-term care, and caregiver costs. Effectiveness was measured by quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios (ICERs) were calculated using QALYs gained combined with costs incurred. Costs and QALYs were discounted at 3% annually in the lifetime horizon model. Model inputs were taken from findings from the Access program for emergency room patients in rural New Mexico from May 2015 to February 2017 and existing literature. One-way and Monte Carlo sensitivity analyses were also conducted.
Results: Compared with no network, patients treated in a Teleneurology network had a cost savings of $28,598 for the 90-day horizon and $54,925 in the lifetime horizon. Incremental QALYs increased from 0.01 for the first year to 0.13 over a lifetime. Overall, results were robust in both Monte Carlo and one-way sensitivity analyses. With cost savings ranging from $21,000 to $106,000 and QALYs gained from .08 to 1.56. The model also shows that the rural hospitals would be able to maintain patients who were not transferred for a gain to the rural hospital of $4.2 million per 100 patients per year.
Conclusion: A Neuro-Emergent Telemedicine Consultation Program demonstrates significant savings and improved quality of life. Unlike other telemedicine programs, ACCESS has shown to be cost-effective in both the 90-day and lifetime horizons.

Learning Objectives:

Andrew L. Hollander

Senior Program Manager
University of New Mexico - Department of Neurosurgery

Andrew L. Hollander PhD, MBA, PMP, is the Senior Program Manager with the University of New Mexico Health Sciences Center ACCESS Program. He is charged with project management of the design, development and delivery of a sustainable service providing neuro-emergent telemedicine consultations to Emergency Departments throughout the state of New Mexico. He was trained as an academic biologist receiving his PhD from the University of Massachusetts. Andrew worked first at University of Notre Dame as an NIH Post-Doctoral Fellow, then spent 12 years in University administration primarily involved with IT projects, earning a MBA in the process. The next 14 years Hollander was a Senior Project Manager with a company implementing large Enterprise Resource Planning (ERP) systems. After several years of retirement he was intrigued by and coaxed back to work as the first full time employee on the ACCESS project.


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EP-152 - Cost-Utility of a Neuro-Emergent Telemedicine Consultation Program

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