A day-long, 220-mile road trip to see a patient with an injured knee convinced a Delaware orthopedic surgeon there are better, faster, and more inexpensive ways to practice medicine.
And that’s how Dr. Alfred Atanda, Jr., a pediatric orthopedic surgeon and sports medicine specialist at the Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., became extremely interested in telehealth. In fact, Atanda is so interested in how telehealth can be used in many instances to expedite patient care, cut wait times for patients and save money, he recently studied the impact telehealth is making on the sports medicine program at Nemours.
In a recent study of 120 patients younger than 18 who had at least one telemedicine visit between September 2015 and August 2016, Atanda compared the total time of a patient visit, the percentage of time spent with the attending surgeon and wait time against data from regular office visits.
The results show that patients and families who use telemedicine for sports medicine appointments saved an average of $50 in travel costs and 51 minutes in waiting and visit time. Each telemedicine visit also saved the health system an average of $24 per patient, according to the Nemours study.
Atanda found that the labor cost associated with seeing a patient during a traditional 33-minute office cost $114 when wages and time are factored in for the physician, the nurse or medical assistant and the check-in staff. In comparison, labor costs—primarily the physician’s time—declined by 20% to $91 for a telehealth visit.
A patient seeing a sports medicine doctor at Nemours spent on average 68 minutes, which includes an average wait time of 33 minutes and 35 minutes being seen by the doctor and support. In comparison, the average telehealth visit was 17 minutes, but the actual time spent directly with the doctor was 15 minutes vs. just over 5 minutes, with the actual time spent with the doctor during a traditional office visit. “We wanted to look at how telemedicine could benefit patients within a particular specialty such as sports medicine,” Atanda says. “As the healthcare landscape continues to evolve and the emphasis on value and satisfaction continues to grow, telemedicine may be utilized by providers as a mechanism to keep costs and resource utilization low.”
Telehealth won’t replace all traditional office visits for a sports injury. For example, an initial visit will be required to evaluate a patient who hurt his knee during a sporting event. But many times parents were taking time off from work and their children out of school to drive an average of 85 miles for routine follow-up visits at Nemours, which has a specialty in sports medicine treatment for children.
“In a lot of instances parents and patients were coming a long way just to have me read them the results of an MRI, adjust a brace or ask if they should seek a second opinion,” Atanda says. “Those are the types of patient visits that can be handled by telehealth.”
Atanda began an interest in telemedicine when he made a two-hour drive at the request of a friend to evaluate the injured knee of the friend’s son. “When I got there the patient’s real issue was how to properly adjust a knee brace, and the patient told me he couldn’t believe we drove that far just for that and suggested we just do Facebook Live the next time,” Atanda says. “On the two-hour drive home I thought about all of the inefficiencies and what could be done better.”
From his study and other post-telehealth surveys, Nemours found a high level of patient satisfaction with digital doctor visits. After each visit, parents were asked to complete a five-item satisfaction survey. The Nemours research found that 91% of parents considered the mobile app for a telehealth visit easy to download, 98% of parents indicated they would be interested in future telemedicine visits and 99% of parents would recommend telemedicine to other families.
Telehealth has many upsides when it comes to reducing costs and improving care, Atanda says. In general telehealth can help reduce labor costs, save patients and providers time and free up clinic and hospital office and treatment space for other use, he says. “There’s lots of efficiency to be gained by telehealth.”