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How Telemedicine Saved One VA Hospital $64K A Year

The Vermont hospital's remote care platform helps veterans who might otherwise have to travel hundreds of miles for one visit.

By Eric Wicklund

- A rural New England VA hospital is saving roughly $64,000 a year in travel costs through telemedicine, according to a recent study.

That figure makes up less than 4 percent of the total travel budget of the VA Hospital in White River Junction, Vt. – a “modest” savings, according to the study’s authors. But it’s still significant to a national healthcare network that reimburses veterans and caregivers some $1 billion a year to travel to and from VA hospitals.

More importantly, the study, conducted by researchers from the VA hospital, Dartmouth-Hitchcock Medical Center and Dartmouth College and recently published in Telemedicine and e-Health, found that telemedicine programs saved veterans an average of 142 minutes and 145 miles per healthcare visit between 2005 and 2013 (the average veteran made 3.1 trips per year to a VA hospital, with the high mark being 63 trips in a year). Those numbers are much more compelling to veterans who might be traveling as much as 260 miles round-trip for an appointment, and to clinicians struggling to accommodate the number of veterans needing healthcare services.

“In this study, we demonstrated that, at least in a rural setting, telemedicine is able to reduce patient travel significantly with corresponding savings in time,” the researchers wrote. “Within the VA system, this results in a reduction in travel payment disbursements, although this savings is currently modest and thus is unlikely to justify the use of telemedicine alone.”

The study did note an increase in telemedicine use over the eight-year time frame. The White River Junction VA hospital actually saved an average of $18,555 per year in travel reimbursements, though in the final year of the study that savings stood at $63,804. Researchers also noted that the hospital draws patients from a large geographic area, with veterans generally travelling longer distances for healthcare appointments.

While the savings in travel reimbursements – the VA system is the only healthcare system to pay its patients for their travel – is considered modest, the researchers said telemedicine’s value is proven in other areas, not least of which in convenience to veterans and clinicians. They noted studies indicating remote care platforms reduce specialty consultations by 20 percent. Other studies have tied remote care to improved clinical outcomes, reduced chronic care costs, improved medication adherence and better morale among both veterans and caregivers.

In studying telemedicine at a VA hospital, the researchers – Jack E. Russo, MD, Ryan R. McCool, MD, and Louise Davies, MD, MS – noted their findings can’t necessarily be applied to the rest of the healthcare ecosystem.

“This study was performed within the VA healthcare system, which is uniquely positioned to engage in telemedicine in that it is not constrained by interstate licensing requirements or traditional models of physician reimbursement - often cited as one of the barriers to broad adoption of telemedicine,” they wrote. “Within this context, reducing unnecessary consultations and minimizing face-to-face volume by the use of telemedicine are beneficial, whereas these outcomes may not be desired in practice settings with fee-for-service reimbursement structures.”

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