1. Resource Savings, Family and Societal
Benefits of A Statewide Pediatric
Telemedicine Program
D.D.Fritch-Levens, MSN, MHA, RN
Children’s Healthcare of Atlanta

2. Locations
Children’s Healthcare of Atlanta
• Children's serves our community with three hospitals and
17 neighborhood locations, including four Immediate Care
Centers and a Primary Care Center.
… at Egleston … at Scottish Rite … at Hughes Spalding
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3. Current Program Offerings
Subspecialist
at Scottish Rite
TeleEmergency at
EG and SR
Subspecialist
at Egleston
TELEMEDICINE PROGRAM
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4. Our Patients…Our Community
• We have served 1,372 patients since inception
• 2009: 88
• 2010: 461
• 2011: 823
• Patients served live in 74 of the Georgia’s 159
counties
• All outside of the MSA
• Representing 47% of Georgia’s counties.
• 78% of our patients are covered by Medicaid /CMO’s
4 * 2011 Volume = January-December

5. Program Offerings
• Allergy and Immunology (1) Coming soon…
• Cardiology (1)
• Child Abuse (3) • General Surgery (2)
• Cystic Fibrosis (1)
• Emergency (64)
• Fetal ECHO (9)
• Gastroenterology (1)
• Nephrology (2) CHOA Physician Credentialing
• Neurology (3) 100
88 91
• Orthopedics (1) 80
• Pulmonologist (1) 60 64 64
ED
40
• Rheumatology (1) 20 27 29
Specialist
• Neurosurgery (1) 0
2009 Current Future
• Endocrinology (1)
• Urology (1)
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6. Growth Since Inception
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7. Benefits
• Builds stronger statewide relationships
• Convenience
• Miles
• Hours
• Work
• School
• Research – Abstract submitted and approved by
Pediatric Academic Society
“Resource Savings, Family and Societal Benefits of a
7 Statewide Pediatric Telemedicine Program”.

8. Objective
 To evaluate the overall resource savings that a
Statewide Telemedicine (TM) Program for Children
can bring to patients, families and society
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9. Barriers to Pediatric Sub-Specialty Care
• Limited number of pediatric subspecialists
• Regionalization of subspecialists/Distance to care
• Access to and limited public transportation
• Direct and Indirect costs for seeking care
• Direct costs:
• Travel time
• Gas and car wear and tear
• Medical transports for chronically ill (Medicaid vans
and others)
• Indirect Costs/Opportunity Costs
• Time from work
• Time from school
• Impact on remaining family (caring for other
children, facilitating transport etc)
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10. Gas Prices
http://www.GasBuddy.com/gb_retail_price_chart.aspx?city1=USA
Average&city2=&city3=&crude=nutmeg=36&units=us
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11. 2011 Data
Year to Date…Per visit: Mean Median Range
Miles Saved 310 344 72-524
Cost of miles saved $170 $189 $40-$288
Hours Saved Traveling 5.6 6.0 2-9
School days 86% of our patients would have missed
*Children greater than 5 y/o school to travel to Atlanta
Work Days Missed >80% of our parents would have missed a
*One adult present full day of work to travel to Atlanta
Overall cost of miles saved: $118,134 (0.55/mile)
476 less days of work missed - Impact on Workforce
476 less cars in Atlanta - Clean Air
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12. Summary of Findings
• Telemedicine represents significant direct cost
savings in decreased travel time and expenses for
patients & families.
• Indirect cost savings include time saved in travel
that can be reallocated to school, work or other
societal benefits.
• The high use by patients with Medicaid reinforces
that telemedicine can improve access to care for
this often underserved population.
• Additional benefits can also be seen as Medicaid
patients and those needing assistance in travel
(from family or others) can have these resources
also reallocated.
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13. Data Collection
 Use of data:
• Measure by region
• Marketing
• Benefits to families by Counties
 How is the data collected on an ongoing basis?
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14. Mileage Table
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15. Daily Reconciliation/Utilization
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16. Excel Formulas
Miles Saved
Time Saved
Cost of Miles Saved
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17. Questions?
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18. Recognition
Resource Savings, Family and Societal Benefits of a Statewide
Pediatric Telemedicine Program:

Harold K. Simon, MD, MBA 1,2,3
 Daniel A. Hirsh, MD 1,2,3
 D.D. Fritch-Levens, RN, MSN, MHA 2
 Cyndie Roberson RN 2
 Mary Joyce Bacon 2
 Linda Cole, RN, MBA 2
 Stephanie Fessler, MD 1
 Larry A. Greenbaum, MD, PhD 1,2
 Michael McConnell, MD 1,2,4
 1Department of Pediatrics, Emory University School of Medicine
 2Children’s Healthcare of Atlanta
 3Department of Emergency Medicine, Emory University
 4Sibley Heart Center
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