The Impact of a Telehealth Web-based Solution for ...The

318 views
234 views

Published on

Published in: Health & Medicine, Business
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
318
On SlideShare
0
From Embeds
0
Number of Embeds
1
Actions
Shares
0
Downloads
5
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide
  • 14/25 is 44% avoided transport
    Despite transport or not 77% consults able to make rec changes which even though specific changes were not noted it was to better serve the patient
  • Avoidance transfer rate 44%
  • Avoidance transfer rate 44%
  • Hospital can be better prepared to manage patients upon arrival
  • The Impact of a Telehealth Web-based Solution for ...The

    1. 1. The Impact of a TelehealthThe Impact of a Telehealth Web-based Solution forWeb-based Solution for Neurosurgery Triage andNeurosurgery Triage and ConsultationConsultation Monica Moya, Jessica M. Valdez,Monica Moya, Jessica M. Valdez, Dr. Howard Yonas & Dr. Dale C. AlversonDr. Howard Yonas & Dr. Dale C. Alverson University of New Mexico Health SciencesUniversity of New Mexico Health Sciences Center, Albuquerque, New MexicoCenter, Albuquerque, New Mexico
    2. 2. IntroductionIntroduction HYPOTHESESHYPOTHESES A Telemedicine Web-based solution through whichA Telemedicine Web-based solution through which brain CT images could be viewed by a consultingbrain CT images could be viewed by a consulting neurosurgeon for use in triage decisions regardingneurosurgeon for use in triage decisions regarding the transfer of neurosurgical patients from ruralthe transfer of neurosurgical patients from rural areas to a tertiary care neurosurgical center willareas to a tertiary care neurosurgical center will result in:result in: 1. 25% avoidance of transfers and1. 25% avoidance of transfers and 2. 25% management recommendation changes2. 25% management recommendation changes independent of the transfer decisionindependent of the transfer decision
    3. 3. IntroductionIntroduction Possible BenefitsPossible Benefits  Allows the neurosurgeon to make a more informedAllows the neurosurgeon to make a more informed decision regarding the transfer of the patient, as welldecision regarding the transfer of the patient, as well as the acute patient managementas the acute patient management  Allows for more rational use of limited resources atAllows for more rational use of limited resources at the tertiary care center and reduces costs by reducingthe tertiary care center and reduces costs by reducing the number of transfersthe number of transfers  Increases revenue for the rural community hospitalsIncreases revenue for the rural community hospitals due to the decreased transfer rates and keepingdue to the decreased transfer rates and keeping patients locally for care and monitoringpatients locally for care and monitoring  Reduces the anxiety for those who would not benefitReduces the anxiety for those who would not benefit from a transfer and may receive treatment at theirfrom a transfer and may receive treatment at their home institutionhome institution
    4. 4. MethodsMethods  Medical images produced at a referring hospitalMedical images produced at a referring hospital were sent to the consulting hospital via awere sent to the consulting hospital via a secure/HIPAA compliant web-based programsecure/HIPAA compliant web-based program called IMEDCONcalled IMEDCON  Evaluated cases which required NeurosurgeryEvaluated cases which required Neurosurgery consult from November 2007 to October 2008consult from November 2007 to October 2008  Medical images received by the consultingMedical images received by the consulting physicians were then coupled with 3 yes-nophysicians were then coupled with 3 yes-no questions in order to gather the data necessaryquestions in order to gather the data necessary to test the hypothesesto test the hypotheses
    5. 5. Methods continued…Methods continued…  The three questions:The three questions: 1.1. Before reviewing the case with the supportingBefore reviewing the case with the supporting information, based on your current knowledge wouldinformation, based on your current knowledge would you have accepted this patient for transport?you have accepted this patient for transport? 2.2. After reviewing the case with the supportingAfter reviewing the case with the supporting information, did you accept this patient for transport?information, did you accept this patient for transport? 3.3. Did your management recommendations change?Did your management recommendations change?  Answers to these questions were then compiled in aAnswers to these questions were then compiled in a database by a system support specialistdatabase by a system support specialist affiliated withaffiliated with IMEDCON.IMEDCON.
    6. 6. ResultsResults  At UNMH there were 39 consultations from 8At UNMH there were 39 consultations from 8 referring hospitals during the study periodreferring hospitals during the study period  25/39 (64%) of consultations were considered to be25/39 (64%) of consultations were considered to be requests for transportsrequests for transports  After review of CT only 14/25 (56%) cases actuallyAfter review of CT only 14/25 (56%) cases actually resulted in transport and thus 44% of transports wereresulted in transport and thus 44% of transports were avoidedavoided  17/39 (44%) of the neurosurgeon consultations17/39 (44%) of the neurosurgeon consultations resulted in recommended management changesresulted in recommended management changes independent of transportindependent of transport  56% of those not transported56% of those not transported  21% of those transported21% of those transported
    7. 7. Results continued…Results continued… Hypothesis 1Hypothesis 1  Results exceeded an expected avoidanceResults exceeded an expected avoidance transfer rate of 25%transfer rate of 25%  In 44% cases, neurosurgeons with telephoneIn 44% cases, neurosurgeons with telephone consult only would have accepted the patientconsult only would have accepted the patient for transport but upon the availability of thefor transport but upon the availability of the patient images they changed their decision inpatient images they changed their decision in 44 % of cases and the patient remained at44 % of cases and the patient remained at their local healthcare facility.their local healthcare facility.
    8. 8. Results continued…Results continued… Hypothesis 2Hypothesis 2  Results exceeded expected managementResults exceeded expected management recommendation changes of 25%recommendation changes of 25%  Using the Web-based telemedicine system,Using the Web-based telemedicine system, neurosurgeons made managementneurosurgeons made management recommendation changes in 44% casesrecommendation changes in 44% cases independent of transferindependent of transfer
    9. 9. SummarySummary  Our data suggests a web-based telemedicineOur data suggests a web-based telemedicine triage system:triage system:  Helps physicians make more informed and timelyHelps physicians make more informed and timely transfer decisionstransfer decisions  Helps to decrease unnecessary transfers andHelps to decrease unnecessary transfers and avoidance of costsavoidance of costs  Avoids the unnecessary use of limited resources andAvoids the unnecessary use of limited resources and beds at the Level 1 trauma centerbeds at the Level 1 trauma center  Allows patients to remain in their communities closerAllows patients to remain in their communities closer to family supportto family support  Is a relatively simple and cost effective approach forIs a relatively simple and cost effective approach for head trauma triagehead trauma triage
    10. 10. Questions or Comments?Questions or Comments?  For additional Information and ReferencesFor additional Information and References contact:contact: Monica Moya: momoya@salud.unm.eduMonica Moya: momoya@salud.unm.edu

    ×