As someone who has spent a huge amount of time attempting to persuade acute trusts in the UK that telehealth is in their interests (with, I’m glad to say, a modicum of success more recently) it is good to see this paper entitled The Financial Impact of a Pediatric Telemedicine Program: A Children’s Hospital’s Perspective in the July 2013 edition of the Journal of Telemedicine & e-Health (freely accessible). The key finding is that what they call telemedicine (which is actually a mix of patient:clinician and clinician:clinician) can substantially increase hospital revenue in an environment where there is a choice of specialist hospital.
Obviously there are many aspects of healthcare, most notably reimbursement, that are very different in the US, so the readover to the UK is far from perfect. However the mechanisms – of enabling hospitals with significant expertise to increase activity by supporting clinicians in the community and in remote hospitals, and supporting patients in the community instead of in hospital – look to align well with the NHS’s current objectives of improving patient outcomes whilst reducing cost. In particular it would seem directionally to support the case for fewer, larger, centres of expertise.
As the authors point out, the study has its weaknesses – most notably that it is a ‘before and after’ study looking only at revenue, without comparing clinical data. Of course it only covers children too, although the effects look to be generally applicable – let’s hope that a similar study for adults is underway.