Effects of telemedicine triage on efficiency and cost-effectiveness in spinal care
| Autor: | Shari Cui, Cara L. Sedney, Scott D. Daffner, Michelle J. Large, Sherri K. Davis, Leslie Crossley, John C. France |
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| Rok vydání: | 2020 |
| Předmět: |
Telemedicine
Referral Cost effectiveness Office visits Cost-Benefit Analysis Context (language use) 03 medical and health sciences 0302 clinical medicine Medicine Humans Orthopedics and Sports Medicine Referral and Consultation health care economics and organizations Retrospective Studies 030222 orthopedics business.industry Electronic medical record medicine.disease Triage Spine Ambulatory Surgery Neurology (clinical) Medical emergency business 030217 neurology & neurosurgery |
| Zdroj: | The spine journal : official journal of the North American Spine Society. 21(5) |
| ISSN: | 1878-1632 |
| Popis: | BACKGROUND CONTEXT Ambulatory spine referral triage must be optimized to improve both quality of care and access to specialists. PURPOSE To evaluate cost savings in an existing model of telemedicine/electronic-triage for ambulatory spine referrals. STUDY DESIGN/SETTING Retrospective review. Institutional spine center. PATIENT SAMPLE All patients/referrals made to the institutional spine center of a tertiary medical center from 2011 to 2014 were included in the data analysis. OUTCOME MEASURES Cost savings and efficiency was evaluated based upon intake to appointment time, rate of referral to surgeons versus nonoperative providers, additional testing required, and extrapolated cost savings based on estimated avoidance of unnecessary office visits and travel. METHODS All ambulatory spine referrals electronically triaged (E-triaged) from 2011 to 2014 were analyzed. The E-triage database was mined for data from intake until triage completion. Hospital electronic medical record system was mined for data on initial clinic visit, tests ordered, follow-up appointments, and presence of surgical encounters. Financial savings from avoiding unnecessary visits were estimated. RESULTS There were 16,174 records created from 2011 to 2014, of which 10,832 were E-triaged by spine surgeons. E-triage generated 3,718 nonoperative provider visits within our healthcare system. The “saved” surgical consult that was avoided resulted in total estimated savings of $793,835 to the patient population; 4,446 patients were deemed surgical and were offered appointments with a spine surgeon. CONCLUSIONS Appropriate triage of ambulatory spine referrals improves access and quality of care. E-triage resulted in $800,000 cost savings. Further studies are required to fully evaluate the effects of an E-triage system on ambulatory spinal care. |
| Databáze: | OpenAIRE |
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