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ePoster Presentations

EP-151 - Does Providing Inpatient Telemedicine Consultative Services Save Money

Monday, April 30
9:55 AM - 10:10 AM
Location: Education Zone, Booth 2416, Screen 5

Geisinger is an integrated healthcare system, having more than 29,000 employees, providing care for individuals in over 40 counties spread from central to northeast Pennsylvania. There are 3 tertiary, 2 community acute care facilities and one inpatient rehab facility. Geis inger has a growing health plan with over 300,000 members and a Group Practice with more than 1000 providers. Many of its clinic facilities are in rural counties with limited healthcare access. As such, patients in rural areas often face prolonged wait time with delays in diagnosis and appropriate treatment when consultation with specialty services is required. In 2012, Geisinger implemented an inpatient Telemedicine program which allowed physicians and patients located onsite at one hospital to receive specialty consult services located at another Geisinger campus. Many subspecialty medicine services were represented and provided telemedicine consultation. For many of the departments, the number of consultations was less than twenty a week, and in some cases, less than ten a week. This would mean that in order to provide consultative services at the satellite hospitals, departments had two options. They could require their physicians to provide coverage and remain on site in the rural facilities, with a subsequent loss in income because of the low volume of patients and episodic nature of the consults. Alternately the different departments could provide coverage by having their physicians drive to the facility. However, many of the facilities are located quite far away with an average travel time greater than 30 minutes. Two of the facilities are approximately an hour and a half away. This travel time represents a significant increase in non-productive time and energy for the consulting physicians; for the most distant hospitals it represents almost half of a work day. Long transit time leads to delays in signing out other cases, or responding to critical changes that can affect patient's care and outcomes.
After the implementation of the Telemedicine service, 1800 telemedicine consults were generated within a 5 year period. A retrospective study was performed to analyze the average number of consults per department and generate a volume analysis. Statewide average physician salaries for each specialty were determined in order to characterize the cost of non-productive downtime. Average transit time was calculated for each facility. This enabled us to determine what the average cost of having a physician onsite would require. It also enabled us to determine the number of man hours lost and cost of long transit. The study found that there is a significant cost-savings associated with the inpatient Telemedicine program. Approximately three million dollars was saved over the course of 5 years by preventing increases in provider non-productive time, preventing increase in provider staffing without a commensurate increase in revenue, and decreasing transit time. It was also estimated that the average physician would save approximately 1.5 hours driving per work day due to the Telemedicine consult service.

Learning Objectives:

Chancey Christenson

Clinical Informatics Fellow
Geisinger Medical Center

Chancey Christenson MD, MPH is a second year Clinical Informatics Fellow at Geisinger Medical Center. He is a Board Certified Clinical Pathologist, and Board- Eligible in Transfusion medicine. He received Fellowship training at Geisinger Medical Center and the New York Blood Center, and attended residency and Medical School at Tulane University School of Medicine. His interests in Informatics include Telemedicine, Machine learning, and how technology can be used to help physicians with their workload, including Clinical Decision Support and Computer Aided Diagnosis.

Presentation(s):

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John Mcilwaine

Medical Director for the Center for Tele-Health and eICU Program
Geisinger Medical Center

John McIlwaine, DO, MBA, FCCP is the Medical Director for the Center for Tele-Health and eICU Program at Geisinger. He is a certified practicing critical care physician and clinical informatician and has been in leadership roles, locally, regionally and nationally and providing care via telehealth solutions for over a decade. He coauthored a publication on tele-ICU in the Journal of American Medical Association, and is a member of the American Medical Informatics Association, the American Tele-medicine Association, the American Association of Physician Leaders, the Society of Critical Care Medicine, and a fellow of the American College of Chest Physicians.

Presentation(s):

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