Telemedicine could eradicate many expensive ED visits

More than 25 percent of pediatric “emergency” visits could be conducted online

A community-wide study in upstate New York found that nearly 28 percent of all visits to the pediatric emergency department could have been replaced with a more cost-effective Internet doctor’s “visit,” or telemedicine, according to investigators from the University of Rochester Medical Center. The Rochester team will present these findings and more at this year's Pediatric Academic Society Meeting, to be held Friday, May 2 through Tuesday, May 6, in Honolulu, Hawaii.

“We learned that more than one in four local patients are using the pediatric emergency department for non-emergencies,” said Kenneth McConnochie, M.D., M.P.H., the study’s lead investigator and a professor of Pediatrics at the University of Rochester’s Golisano Children’s Hospital at Strong. “This mismatch of needs and resources is inefficient, costly and impersonal for everyone involved.”

McConnochie and colleagues – who direct Health-e-Access, a Rochester-based telemedicine program that provides interactive, Internet-based health care “visits” to diagnose and treat routine childhood symptoms in 19 urban and suburban schools and childcare centers – analyzed data from 2006, tracking all pediatric (younger than 19) visits to the largest emergency department in the city.

Given experience with over 6,000 successfully-managed telemedicine visits that illustrate the extent of technology’s capabilities, unique diagnoses from more than 22,000 pediatric ED visits were coded into various categories – first, ailments that virtually always prove manageable by telemedicine, such as ear infections or sore throats; second problems that are usually treatable through telemedicine, but not always, such as asthma attacks; and finally, conditions that were usually beyond the scope of the technology.

Nearly 28 percent of ED visits fell into that first category; had these same problems been handled by telemedicine, this community would have had at least 12,000 fewer ED visits that year.