Is Telemedicine a Viable Alternative to Ambulance Ride and ER Visit?

New data suggests that telemedicine for older adults in independent and assisted living facilities decreases emergency room use and is a big hit among patients and families.

The results of a URMC study that began in 2010 were recently presented at the American Geriatrics Society annual meeting by Manish Shah, M.D., M.P.H., associate chair for research in the Department of Emergency Medicine.

The study was designed to find out if telemedicine could reduce emergency room visits without compromising quality of care.  Approximately 1,500 older people participated, and the study evaluated more than 500 telemedicine encounters. Results showed that telemedicine eliminated nearly one in five ER visits. Also, 90 percent of the cases required no additional care by a primary care physician; and in 97 percent of the cases doctors, physician’s assistants, or nurse practitioners were able to make a definitive diagnosis and treatment recommendation.

A rapidly growing population of older adults is prompting health care systems to seek alternative care models. Common conditions such as pneumonia and infections can be deadly if not treated early, but they often do not require an ambulance ride and emergency room evaluation, which costs an average of $1,500. However, the older adult population visits ERs nearly 20 million times a year and doctor’s offices about 95 million times.

In January New York Gov. Andrew Cuomo signed a bill that will take effect in 2016, requiring commercial and government health plans to recognize and cover telemedicine services, which uses videoconferencing technology to allow healthcare professionals to evaluate patients. It should cost much less, and a cost analysis is underway.

The pilot program was so popular among the study participants, Shah said, that 87 percent reported they would choose a residential facility based on whether it had telemedicine available as part of the package.