Study: Telemedicine offers cost-effective alternative to ED visits

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Nearly 28 percent of all visits to the pediatric emergency department (ED) could have been replaced with a more cost-effective internet doctor’s “visit,” according to a community-wide study conducted at the University of Rochester Medical Center in Rochester, N.Y., and presented at the 2008 Pediatric Academic Societies annual meeting in Honolulu.

Common ailments, such as ear infections and sore throats, proved manageable by telemedicine during a one-year-period, according to university investigators.

"We learned that more than one in four local patients are using the pediatric emergency department for non-emergencies," said lead investigator Kenneth McConnochie, MD, a professor of pediatrics at the University of Rochester's Golisano Children's Hospital at Strong. "This mismatch of needs and resources is inefficient, costly and impersonal for everyone involved."

McConnochie and his colleagues analyzed data for all pediatric visits to the largest emergency department in the city. Based on their research, they determined at least 12,000 visits were ones they routinely treat with success via telemedicine.

“This would’ve not only freed up emergency resources to people who needed them more – it would have afforded smaller co-pays for parents and more timely, personalized care,” McConnochie said. On average, 87 percent of the telemedicine visits are handled by the child’s own family pediatrician, researchers said.

In related research presented at the meeting, McConnochie suggested that telemedicine will also serve the ultimate objectives of insurers as well community–better quality care at a lower price.

He said insurers typically have been wary of embracing the technology, fearing the convenience may lead parents to use medical care more often and drive up costs. Another community study from Rochester suggests the exact opposite – that in the long run, insurers actually would realize cost savings – more than $14 per child per year in that local community.

In that study, researchers analyzed two groups of children that were almost identical – except one had access to their doctor’s office, the ED, and telemedicine technology for care, and the second had only the first two options. They tracked how often families used services and which ones.

“We found that the first group of families, which had access to telemedicine for their children, did in fact access care for illness overall nearly 23 percent more often than the second group,” McConnochie said.

But he noted that since ED visits among these children with telemedicine access were nearly 24 percent less common and since these visits cost about seven times the cost of a doctor office or telemedicine visit, the telemedicine group ultimately still cost the insurers less per child over the course of a year.