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Analysis

Pediatric Telemedicine Stems Utilization, Points to Cost Savings

By Mandy Roth  
   July 09, 2018

Nemours study provides look at usage and impact of 24/7 telemedicine for pediatrics; redirects nearly 28% of patients from ED.

Direct-to-consumer pediatric telemedicine significantly reduces ED and urgent care utilization, along with the associated costs, according to a peer-reviewed study conducted by Nemours Children's Health System and published by Telemedicine and e-Health Journal in April.

Cost and Utilization Highlights
 

  • Without the telemedicine service, 27.9% of parents would have visited the ED; a projected savings to the Florida healthcare system of approximately $113.9 million based on comparative data from the Florida ER Utilization Report.
     
  • Another 36.6% of parents would have gone to an urgent care center; researchers did not calculate the potential financial impact of this measure.
     
  • Only 6% of the parents stated they would have done nothing if the telemedicine service was not available.
     

The study demonstrates that "pediatric telemedicine programs can reduce costs by redirecting patients from more costly services," says one of the study's authors, Patricia Solo-Josephson, MD, telehealth physician for Nemours Children's Clinic and clinical assistant professor for University of Central Florida College of Medicine, Orlando.

"This is important because, to our knowledge, this is the first time descriptive data has been analyzed on the use of a 24/7 pediatric [telemedicine] platform," says Dr. Solo-Josephson. Previous studies, she says, have focused on adult populations.

How and Why Parents Use Telemedicine Services
 

The study also details when parents use telemedicine services, wait times, reasons for calls and satisfaction with the service.

  • Parents call most often on Saturdays and Sundays with peak volumes between 4:00 p.m. to 8:00 p.m. (25.9% of callers), closely followed by 8:00 p.m. to midnight (25.7% of callers).
     
  • Median visit wait time was just over two minutes; median treatment time was just over 12 minutes.
     

Topping the list of reasons parents called the service:

  • Skin-related concerns (18.7%)
     
  • Upper respiratory symptoms (17.5%)
     
  • Fever (15.2%)
     
  • Gastrointestinal issues (9.7%)
     

"Parental satisfaction was very high," says Dr. Solo-Josephson. Over 93% of parents rated the physician care they received through Nemours CareConnect as five out of five stars.

The Study
 

Nemours Children’s Health System, a pediatric nonprofit health system of hospitals and clinics, launched Nemours CareConnect (NCC), a telemedicine initiative, which provides 24/7 direct-to-consumer service via the Internet or a mobile application for families with children from birth to age 18.

The study examined the first 1,000 visits to the service for patient demographics, chief complaints, visit experience, and parent satisfaction. A post-visit survey identified what action parents would have taken if NCC were not available. Board certified pediatricians provided telemedicine care in Florida, Pennsylvania, and Maryland, plus nights and weekends in Delaware. After the timeframe of the study, NCC expanded operations, now offering 24/7 service in Delaware, as well as Georgia and New Jersey.

What's Next
 

Next up, Nemours is evaluating use of pediatric telemedicine during national disasters—an investigation prompted by increased calls to the service during Hurricane Irma in 2017.

As pediatric telemedicine continues to grow, the Nemours physician says it will play an important role in helping health systems better meet the needs of parents.

"Direct-to-consumer 24/7 telemedicine is a complement to the medical home," says Dr. Solo-Josephson. It's important for consumerism to create a full-service health system that aligns with our primary directive, which is written from our patients’ perspective: 'Help me receive exactly the care I need and want, how and when I need and want it.' "

Mandy Roth is the innovations editor at HealthLeaders.


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