In a pilot program that began two years ago, Banner Health is proving that telemedicine programs can reduce the number of hospitalizations and cut the cost of health care. When patients in the program were hospitalized, their stays were significantly shorter.
Banner Health is a nonprofit health system based in Phoenix and operates 29 hospitals, including three academic medical centers, in seven states. Banner Health is recognized as a top health system for its clinical quality. The health system began an ambulatory care telemedicine pilot as part of the health system’s move toward value-based care in 2013. The pilot included 135 patients with comorbidities. These patients were monitored remotely by primary care physicians and nurses who used in-home monitoring tools, such as blood pressure cuffs and weight scales, to aid in patient assessment. Electronic tablets enabled video consults between patients and caregivers.
The goal of the pilot was to measure telemedicine’s potential for catching warning signs before they became adverse events and to intervene before hospitalizations were needed. Results of the telemedicine pilot included:
- Hospitalizations—Hospitalization rates dropped significantly. Before the pilot, roughly 11 out of 100 patients were hospitalized every month. The number of hospitalizations among the pilot group was cut almost in half to 6 per 100 patients per month.
- Length of stay—For those patients who did need to be hospitalized, the number of patient days was significantly shortened from 90 to 66.
- Cost of care—Cost of care was cut by an impressive 27%. These cost savings came as a result of reduced hospitalization and outpatient costs. In addition, the cost of acute and long-term care dropped by 32%.
The Value of Telemedicine
Health care facilities throughout the U.S. and Canada are turning to telemedicine to provide remote monitoring of hospitalized patients and ambulatory patients alike. Because of the shortage of primary care providers in some states, telemedicine provides a means to care for patients in rural areas and for those who cannot travel to care providers. Telemedicine can also be used for inpatient care. At Banner Health, for example, eICU, a telemedicine ICU initiative, has been implemented to cover 430 ICU beds. An offsite monitoring center receives a feed through video cameras that are stationed in all ICU rooms. Off-site physicians monitor patients in eICU beds and alert onsite clinicians when they spot a problem.
Banner Health believes that using telemedicine has saved as many as 2,000 lives in 2013 alone and plans to add telemedicine capabilities in its skilled nursing facilities and emergency departments. Many health care systems are installing telemedicine capabilities in emergency departments, especially to obtain specialist consultations during night and weekend shifts.
The future of telemedicine and the possible benefits it can offer are on the radar of the Health Resources and Services Administration (HRSA) , a division of the U.S. Department of Health and Human Services. HRSA is devoted to improving access to health care for those who are geographically isolated or economically or medically vulnerable. As an indicator of its support, HRSA is dispersing grants to more than 100 communities in 42 states to support health care in rural areas. These grants include funds to increase resources for telemedicine solutions. Of a total of $22 million in grants, HRSA has earmarked more than $2.3 million for the Evidence-based Tele-Emergency Network Program and an additional $600,000 for Telehealth Resource Centers to expand telemedicine capabilities and measure outcomes for rural patients.