scholarly journals Economic Advantages of Telehealth and Virtual Health Practitioners: Return on Investment Analysis

10.2196/15688 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e15688
Author(s):  
Centaine L Snoswell ◽  
John B North ◽  
Liam J Caffery

Background Telehealth is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The benefit is that it offers the opportunity to redesign the way services are offered. For instance, a virtual health practitioner can provide videoconference consultations while being located anywhere in the world that has internet. A virtual health practitioner also obviates the issues of attracting a specialist medical workforce to rural areas, and allows the rural health service to control the specialist services that they offer. Objective The aim of this research was to evaluate the economic effects of 3 different models of care on rural and metropolitan hospital sites. The models of care examined were patient travel, telehealth using videoconferencing, and employment of a virtual health practitioner by a rural site. Methods Using retrospective activity data for 3 years, a return on investment (ROI) analysis was undertaken from the perspective of a rural site and metropolitan partner site using a telehealth orthopedic fracture clinic as an example. Further analysis was conducted to calculate the number of patients that would be required to attend the clinic in each model of care for the sites to break even. Results The only service model that resulted in a positive ROI for the rural site over the 3-year period was the virtual health practitioner model. The breakeven analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health practitioner model of care. The rural site was unable to recoup its costs within the travel model due to the lack of opportunity for reimbursement for services and the requirement to cover the cost of travel for patients. Conclusions Our model demonstrated that rural health care providers can increase their ROI by employing a virtual health practitioner.

2019 ◽  
Author(s):  
Centaine L Snoswell ◽  
John B North ◽  
Liam J Caffery

BACKGROUND Telehealth is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The benefit is that it offers the opportunity to redesign the way services are offered. For instance, a virtual health practitioner can provide videoconference consultations while being located anywhere in the world that has internet. A virtual health practitioner also obviates the issues of attracting a specialist medical workforce to rural areas, and allows the rural health service to control the specialist services that they offer. OBJECTIVE The aim of this research was to evaluate the economic effects of 3 different models of care on rural and metropolitan hospital sites. The models of care examined were patient travel, telehealth using videoconferencing, and employment of a virtual health practitioner by a rural site. METHODS Using retrospective activity data for 3 years, a return on investment (ROI) analysis was undertaken from the perspective of a rural site and metropolitan partner site using a telehealth orthopedic fracture clinic as an example. Further analysis was conducted to calculate the number of patients that would be required to attend the clinic in each model of care for the sites to break even. RESULTS The only service model that resulted in a positive ROI for the rural site over the 3-year period was the virtual health practitioner model. The breakeven analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health practitioner model of care. The rural site was unable to recoup its costs within the travel model due to the lack of opportunity for reimbursement for services and the requirement to cover the cost of travel for patients. CONCLUSIONS Our model demonstrated that rural health care providers can increase their ROI by employing a virtual health practitioner.


1997 ◽  
Vol 06 (01) ◽  
pp. 92-98
Author(s):  
R. S. Raman ◽  
V.J agannathan ◽  
K. Srinivas ◽  
S. Reddy ◽  
K.J. Cleetus ◽  
...  

AbstractHealth-care is a collaborative endeavor involving a number of individuals and organizations with diverse perspectives. Computer-supported collaboration technologies have great potential to enable health-care providers to improve the quality of care provided to their patients. Such technologies have the potential to overcome barriers to quality health-care in the small, scattered populations of rural areas. Rapid changes in technology are making it more and more possible for collaborative telemedicine to be a part of the practice of medicine. The World Wide Web has amply demonstrated that the globe has shrunk and information from afar is a mere mouse click away. However, the ease with which information is accessed along with the potential disclosure and misuse of personal information has raised serious concerns about the ability to restrict such information to legitimate accesses by duly authorized health-care providers. The authors present their experience in developing a health-care collaboration facility, ARTEMIS, which enabled Web-based access to electronic medical records, and provide a vision of their experiment to provide secure telemedicine for rural health-care practitioners.


2021 ◽  
Vol 10 (1) ◽  
pp. 1-1
Author(s):  
Beheshteh Shamsaee ◽  
Mehdi Bagheri ◽  
Nader Gholi Ghourchian ◽  
Parivash Jafari

Background: Rural health workers (Behvarz) are considered health- care pioneers standing at the forefront of providing services for rural areas. Those health providers need to be optimally educated throughout the country. What can serve this purpose is an integrated high quality "education". Methods: The current descriptive research compared two situations of education quality. To this end 300, rural health workers completed researcher-made questionnaires, including 2 dimensions,7 components and, 80 questions obtained from the analysis of the qualitative process through the fuzzy Delphi method. Results: The results indicated a gap between the current status and desirable situations of qualitative improvement components of rural health workers’ education. The findings also showed that the highest standardized coefficient in the area of education was related to the variable of learning and transfer of education with a coefficient of 0.971. In the area of optimization, the highest standard coefficient for the desirable situation belonged to the interpersonal and functional relationship variable, with the value of 0.978, while the lowest standardized coefficient was related to the variable of information and communication technology (ICT) development as 0.956. Conclusion: In brief, optimal education for the health- care providers is considered an integral part of the health system; therefore, the impact of education on the general health of the people should be taken into consideration. Therefore, there is a need for theoretical and practical exploration of qualitative education towards health system improvement and promotion.


Background: Diarrhea is a main cause of morbidity and mortality in children under 5 years old. Globally it is responsible for approximately four billion cases and three million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism is rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Objectives: To determine the prevalence and demographic characteristics of rotavirus infection in Babylon city, Iraq. Materials and Methods: Fecal samples were taken from children with age range of 6 months to 5 years complained of diarrhea during the period beginning in October 2016 till August 2017. The age, gender, residence, the type of feeding, place of the sample collection and duration of diarrhea were recorded. Specimens were analyzed by Latex test for detection of rotavirus. Results: A total of 349 children presented with diarrhea, the rotavirus antigen was detected in 169 fecal specimens from children with diarrhea (48%). More percentages of positive rotavirus specimens were seen in the 5year of age. No gender differences were observed, meanwhile samples obtained from rural areas and breastfed children showed less rotavirus positive infection. Conclusion: The present study confirms that rotavirus infection is still currently a prevalent gastroenteritis causative agent and required careful clinical attention. Pediatricians and health care providers are needed to be encouraged to take into account the children who at risk for developing rotavirus infection including age, residence and type of feeding.


Background: Diarrhea is a main cause of morbidity and mortality in children under 5 years old. Globally it is responsible for approximately four billion cases and three million deaths annually. In developing countries, it causes two million deaths each year. The major causative organism is rotavirus which is responsible for one-third of hospitalizations with approximately 40% mortality. Objectives: To determine the prevalence and demographic characteristics of rotavirus infection in Babylon city, Iraq. Materials and Methods: Fecal samples were taken from children with age range of 6 months to 5 years complained of diarrhea during the period beginning in October 2016 till August 2017. The age, gender, residence, the type of feeding, place of the sample collection and duration of diarrhea were recorded. Specimens were analyzed by Latex test for detection of rotavirus. Results: A total of 349 children presented with diarrhea, the rotavirus antigen was detected in 169 fecal specimens from children with diarrhea (48%). More percentages of positive rotavirus specimens were seen in the 5year of age. No gender differences were observed, meanwhile samples obtained from rural areas and breastfed children showed less rotavirus positive infection. Conclusion: The present study confirms that rotavirus infection is still currently a prevalent gastroenteritis causative agent and required careful clinical attention. Pediatricians and health care providers are needed to be encouraged to take into account the children who at risk for developing rotavirus infection including age, residence and type of feeding.


2013 ◽  
Vol 30 (2) ◽  
pp. 221-225 ◽  
Author(s):  
A. Clinton MacKinney ◽  
Keith J. Mueller ◽  
Thomas Vaughn ◽  
Xi Zhu

2007 ◽  
Vol 20 (3) ◽  
pp. 345-350 ◽  
Author(s):  
Daniele Alcalá Pompeo ◽  
Maria Helena Pinto ◽  
Claudia Bernardi Cesarino ◽  
Renilda Rosa Dias Ferreira de Araújo ◽  
Nadia Antonia Aparecida Poletti

OBJECTIVE: To know the hospital discharge process in place and the nurses' performance in preparing patients for discharge. METHODS: A descriptive study using semi-structured interviews was used to collect data from 43 patients of medical-surgical units of a major teaching hospital in the state of São Paulo, Brazil. RESULTS: The majority of patients (83.72%) received tailored discharge instructions. However, a great number of patients (72.08%) reported discharge instructions were not given by nurses. Almost a half of patients (48.84%) reported that discharge instructions were given by their physicians. CONCLUSION: The findings of this study provide insights to improve the educational process of new nurses and their preparation to provide effective discharge instructions. There is also a need to design and implement a hospital discharge process that promotes the participation of interdisciplinary health care providers who are involved in patient clinical care. This discharge process might be an effective way to change health care providers' attitude toward discharge instructions.


2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Mohamed Yunus Rafiq ◽  
Hannah Wheatley ◽  
Hildegalda P. Mushi ◽  
Colin Baynes

Abstract Background Numerous studies have examined the role of community health workers (CHWs) in improving the delivery of health services and accelerating progress towards national and international development goals. A limited but growing body of studies have also explored the interactions between CHWs’ personal, communal and professional identities and the implications of these for their profession. CHWs possess multiple, overlapping roles and identities, which makes them effective primary health care providers when properly supported with adequate resources, but it also limits their ability to implement interventions that only target certain members of their community, follow standard business working days and hours. In some situations, it even prevents them from performing certain duties when it comes to sensitive topics such as family planning. Methods To understand the multiple identities of CHWs, a mixture of qualitative and ethnographic methods was utilized, such as participant observation, open-ended and semi-structured interviews, and focus group discussions with CHWs, their supervisors, and their clients. The observation period began in October 2013 and ended in June 2014. This study was based on implementation research conducted by the Connect Project in Rufiji, Ulanga and Kilombero Districts in Tanzania and aimed to understand the role of CHWs in the provision of maternal and child health services in rural areas. Results To our knowledge, this was the first study that employed an ethnographic approach to examine the relationship between personal, communal and professional identities, and its implications for CHWs’ work in Tanzania. Our findings suggest that it is difficult to distinguish between personal and professional identities among CHWs in rural areas. Important aspects of CHW services such as personalization, access, and equity of health services were influenced by CHWs’ position as local agents. However, the study also found that their personal identity sometimes inhibited CHWs in speaking about issues related to family planning and sexual health. Being local, CHWs were viewed according to the social norms of the area that consider the gender and age of each worker, which tended to constrain their work in family planning and other areas. Furthermore, the communities welcomed and valued CHWs when they had curative medicines; however, when medical stocks were delayed, the community viewed the CHWs with suspicion and disinterest. Community members who received curative services from CHWs also tended to become more receptive to their preventative health care work. Conclusion Although CHWs’ multiple roles constrained certain aspects of their work in line with prevalent social norms, overall, the multiple roles they fulfilled had a positive effect by keeping CHWs embedded in their community and earned them trust from community members, which enhanced their ability to provide personalized, equitable and relevant services. However, CHWs needed a support system that included functional supply chains, supervision, and community support to help them retain their role as health care providers and enabled them to provide curative, preventative, and referral services.


2020 ◽  
Vol 35 (6) ◽  
pp. 669-675
Author(s):  
Mehmet Ali Ceyhan ◽  
Gültekin Günhan Demir

AbstractBackground:Shopping centers (SCs) are social areas with a group of commercial establishments which attract customers of numerous people every day. However, analysis of urgent health conditions and provided health care in SCs has not been performed so far.Objective:The aim of the study was to perform a comparative analysis of clients visiting SCs and demographics, complaints, and health care of patients admitted to Emergency Medical Intervention Units (EMIU) located in grand SCs in Ankara, Turkey.Methods:Customer and health care records of nine grand SCs in Ankara from January 1, 2018 through December 31, 2018 were evaluated retrospectively. Health care services in EMIUs of SCs were provided by employed medical staff. Data including demographic characteristics, complaints, treatment protocols, discharge, and referral to hospital of the patients were retrospectively analyzed from medical registration forms.Results:Medical records of nine grand SCs were analyzed. Number of customers could not be obtained in three SCs due to privacy issues and were not included in patient presentation rate (PPR) and transport-to-hospital rate (TTHR) calculation. Total number of customers in the remaining six SCs were 53,277,239. The total number of patients seeking medical care was 6,749. The number of patients seeking health care in six SCs with known number of customers was 4,498 and PPR ranged from 0.018 to 0.381 patients per 1,000 attendants. The median age of the recorded 4,065 patients (60.2%) was 28 (interquartile range [IQR]: 38-21), and 3,611 (53.5%) of the patients admitted to EMIUs were female. The number of patients treated in the SC was 4,634 (68.6%) and 189 patients (2.8%) were transferred-to-hospital by ambulance for further evaluation and treatment. Transportation to hospital was required in 125 patients who sought medical care in six SCs which provided total number of customers, and TTHR ranged from 0.000 to 0.005 patients per 1,000 attendants. No sudden cardiac death was seen. Medical conditions were the primary reasons for seeking health care. The most frequent causes of presentation were laceration and abrasions (639 patients, 9.4%).Conclusion:The PPR and TTHR in SCs are low. The most common causes of presentation are minor conditions and injuries. Majority of urgent medical conditions in SCs can be managed by health care providers in EMIUs.


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