Telemedicine Contribution to Wait Times


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Ontario Telemedicine Network

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Telemedicine Contribution to Wait Times

  1. 1. 3/25/2012The Taming of the Queue 2012Telemedicine’s ContributionContents Telemedicine’s impact: – The Ontario Telemedicine Network (OTN) results – Other studies How telemedicine can reduce wait times while improving access and efficiency 1
  2. 2. 3/25/2012OTN An independent not-for-profit organization primarily funded by the Government of Ontario• Members include all hospitals and hundreds of other health delivery and education organizations in Ontario Partners with: – Federal and Provincial e-Health Organizations – Keewaytinook Okamakanak (Northern Chiefs) Tribal Council Page 3 OTN: Available Everywhere One of the world’s largest & most active TM networks. Programs & services delivered collaboratively at more than 1,400 sites using 2,600 telemedicine systems Page 4 2
  3. 3. 3/25/2012OTN Vision Telemedicine will be amainstream channel forhealth care delivery and education.OTN Goals 3
  4. 4. 3/25/2012OTN “Virtual” Channels 1. Healthcare Office 2. Emergency Care 3. Learning 4. Home and Community2011 Clinical Utilization Clinical Events* 170,875 Annual growth rate 39% Consultants 1,622 Physician Consultants 1,180 * Includes videoconferencing and store-forward telemedicine consultations; Excludes telehomecare 4
  5. 5. 3/25/2012OTN Annual Results 2011 By using telemedicine rather than travelling for an in-person consultation, 170 million km of patient travel was avoided in Ontario 92 million km of travel was avoided in Northern Ontario which would have cost the Northern Health Travel Grant Program $38 million Hospitals avoided 625 admissions/transfers through emergency mental health crisis access Telestroke enabled 187 tPA deliveries that might otherwise have not been possible Using teleophthalmology, Retinal specialists reported to being able to assess 10 patients in 40 minutes vs 2 hours when seen in person 90% of referring physicians said telemedicine improved their ability to manage patients in their own community and 76% reported improved access for their patients.OTN Wait Time Impacts Dermatology consult wait times reduced from 5 weeks to 10 days Endocrinology consult wait times reduced from 4-6 weeks to less than 4 weeks Diabetic retinopathy screening wait times reduced from 6 months to 4 weeks Emergency child & adolescent psychiatry consultation wait times decreased from 6 – 9 months to within 72 hours 5
  6. 6. 3/25/2012OTN Study: Telehomecare in ChronicDisease Management Self-reported data from 813 enrolled patients with CHF and COPD 64 – 66 % decrease in hospital admissions 72 – 74% reduction in emergency department visits 16 – 33% decrease in number of primary care physician visits 95 – 97% reduction in walk-in clinic visits High levels of patient and provider satisfactionOther Published Examples Canada Health Infoway studied digital imaging and found that radiologists were 27% more efficient using the technology Alaska telehealth studied their store-forward ENT service over 16 years and found a reduction in average wait to see an ENT surgeon from 4.2 months prior to telemedicine introduction to 2.1 months after three years of introduction. The VA studied 17,025 chronic disease patients receiving telehomecare and documented a 25% reduction in number of bed days Kaiser implemented PCP to specialist e-consults in San Francisco and found a 13, 18, 26, 42% reduction in the need for a face-to-face visit for Rheumatology, Cardiology, GI and Endocrine respectively 6
  7. 7. 3/25/2012OTN Vision - By 2015 Over 1,000,000 patients served, with improved access to better integrated, quality care Over 40,000 telehomecare patients annually with increased self-management skills and reduced utilization of more expensive health system resources Over 25,000 healthcare providers using telemedicine to collaborate around patient care, best practices and health education 13 Cardiology Clinic Next Available Clinic Jan 31 Feb 10 Feb 18 Mar 1 Nov 21 7
  8. 8. 3/25/2012Telemedicine will make the health caresystem and providers more efficient Reduce unnecessary travel and transfers Enhance provider efficiency through store-forward Leverage lower-cost providers to do more Address geographic maldistribution of providers and associated wait time variation Reduce ED visits and hospitalization rates by improving self-management of chronic disease Improve collaboration among providers Empower new and better models of care deliveryHow can we accelerate adoption? Policy: 1. Overcome systemic payment and payment model barriers to e- consults and provider collaboration 2. Share efficiency benefits among providers and funder Lower the cost and increase the simplicity of telemedicine: 3. Invest in telemedicine service development 4. Develop solutions that fit provider workflow Assist in matchmaking 5. Provide real-time information on available resources and wait times 6. Simplify provider requests and information exchange 8
  9. 9. 3/25/2012 Appendix APPENDIX“Store Forward” or “eConsult”Telemedicine Definition Send pictures and patient data to a specialist for advice or a consultation Examples: dermatology, ophthalmology, ENT 9
  10. 10. 3/25/2012 Ed Brown, CEO 10