Imagine what it would be like if older adults could have access to prompt, quality health care at any time, without ever having to leave their homes. Now this is possible because of tele health.
Tele health refers to a form of technology-assisted health care that facilitates a set of medical services such as remote patient monitoring and electronic communication between patients and medical professionals.
Tele health or telemedicine services were used even before the pandemic owing to the rapid developments in telecommunication technology over the last few decades. Once considered a novelty, this form of health care is gaining traction as a way of reducing costs and improving patient outcomes.
In the United States, for example, when the pandemic reached in March 2020, the use of telehealth services increased from 0.15% of claims to 13.0%.
The current coronavirus pandemic has compelled healthcare providers to reconsider their service delivery models. Due to the fact that older adults are more susceptible to contracting the virus and developing severe complications, their access to medical care is critical, and tele health provides a valuable alternative to face-to-face triage.
Additionally, telehealth enables remote monitoring, in which physiological data such as blood pressure and glucose levels are collected and sent to medical professionals through secure digital platforms. This allows physicians to detect the onset of certain diseases early and prescribe appropriate interventions and treatment without requiring patients to leave their homes, thus reducing the risk of exposure to the novel coronavirus. Oftentimes, this constant stream of physiological information allows for a much more thorough assessment than it’s possible during an in-person doctor visit.
The benefits of tele health for older adults include better access to medical care, prolonged independence, and fewer issues associated with traveling for in-person doctor’s visits. This also has significant financial ramifications.
Policymakers from all over the world are concerned with the sustainability of existing health care systems in light of rising costs and, more specifically, the increasing ratio of health expenditure to GDP.
For instance, Australia’s health care expenditure nearly doubled from 2007 to 2017, and the ratio of health expenditure to GDP went from 8.75% to 10.28%. In the U.S., health expenditure increased by 50% over the same period, and the ratio of health expenditure to GDP went from 15.9% to 17.9%. This has accelerated the need to reduce healthcare costs, as these increases are unsustainable in the long run.
Cost reduction and better access to health care are the two main motivators for the growing interest in implementing telehealth services on a wide scale.
How Does Telemedicine Reduce Health Care Cost?
Telehealth was most often found to minimize health care costs when it was used to cover patient or clinician travel. Savings are more likely to be realized in the public health sector, as other program models, with the exception of the Department of Veterans Affairs, seldom cover patient transportation costs. Because of the volume, it’s also more likely to reduce costs when patient travel is replaced with tele health services rather than physician travel. Another way tele health can reduce healthcare travel costs is by preventing emergency transfers.
Additional savings opportunities replace a portion of in-home visits with remote monitoring that also reduces the rate of hospitalizations.
Tele triage, in which a nurse screens a patient to assess whether tertiary treatment is needed, has also been shown to reduce costs by minimizing hospital visits.
However, we need to note that implementing tele health services has been shown to reduce costs only when a certain caseload is exceeded. This is referred to as the break-even point – the point where savings exceed the initial investment in equipment and staff training. The break-even point depends on the scale of the implementation.
If the medical system has an increased capacity, cost saving stems from the productivity gains associated with tele health implementation. Tele health makes it possible to manage more patients with a similar amount of resources, thus reducing the per-patient marginal cost. For instance, when video consultations are used to replace a portion of the in-person consultations, a medical facility effectively increases the number of patients it can provide services to in the same amount of time.
Tele health also reduced the rate with which patients fail to attend their appointments. When patients don’t show up for an appointment, this raises the marginal cost of all appointments, so the medical facility and medical system as a whole lose money. However, studies show that patients, and especially older patients, are more likely to attend their appointments if they don’t have to travel too far from where they live.
Tele health has also been shown to reduce costs by reducing the number of visits to the emergency department. A good example of the effectiveness of this system is the Emergency Medical Services in Houston.
They established a protocol where an ambulance was dispatched in response to a call, but a consultation with a physician was conducted via videoconference before the patient was taken to the ED. This way, the patients could be more effectively triaged, and some were directed to primary care while others were sent to the ED via personal transportation or ambulance, depending on the circumstances of each case.
This protocol reduced patient transportation to the ED via ambulance by more than half, which means that the team could be dispatched to other calls much faster – by an average of 44 minutes.
These findings illustrate the potential of tele health services to reduce the number of unnecessary outpatient specialist appointments, which results in lower costs.
However, we need to keep in mind that despite all the advantages that large-scale tele health implementation provides, there are still some significant challenges that need to be overcome, such as issues with privacy and confidentiality, regulatory aspects, and reimbursement standards.
The patients would need to have broadband internet, appropriate equipment, and a certain degree of digital literacy that would allow them to take advantage of tele health services. Furthermore, patients with hearing impairments can find it difficult to use these services since many of the existing platforms lack closed caption or other ways to address this issue.
