Arizona Telemedicine Program: Implementing a Statewide Health Care Network

Barker²,

Rodriguez³

et al. 2002

The goal of this study was to determine whether teledermatology referrals differ significantly from in-person referrals with respect to case complexity and diagnosis of cases referred. Teledermatology cases were compared to in-person cases seen by the same university dermatologist who also reviews the teledermatology cases. These were also compared with in-person cases evaluated by a different dermatologist at local clinics using traditional referral patterns. Study parameters included Current Procedural Terminology (CPT) codes as a measure of case complexity, International Classification of Disease (ICD) codes as a measure of case types, and time from referral to actual consultation. The most common CPT codes used for teledermatology were 99241 and 99242 with no significant differences in the frequency of assigned CPT codes for teledermatology versus in-person consultation. An analysis of the diagnostic codes revealed no significant differences between the types of cases referred to telemedicine and those referred for in-person consultation. Time between referral and actual encounter with the dermatologist was significantly shorter via telemedicine than either local or university clinic in-person visits.

Section: Introductionmentioning

confidence: 99%

Telemedicine Versus In-Person Dermatology Referrals: An Analysis of Case Complexity

Barker²,

Rodriguez³

et al. 2002

“…In May of 1997 the Arizona Telemedicine Program (ATP) 17 started providing teleconsultations to rural sites in Arizona. Although the program currently has a number of interconnected sites on the network, this paper is only concerned with seven core sites that primarily send teleconsultation cases to the University of Arizona College of Medicine hub site.…”

Section: Methodsmentioning

confidence: 99%

Fluctuations in Telemedicine Case Volume: Correlation with Personnel Turnover Rates

Hughes²,

Barker³

et al. 2003

Statistical process control (SPC) techniques were used to analyze 5 years worth of telemedicine case volume data from seven remote sites in order to characterize how much fluctuation occurred over time for each site and whether the fluctuation remained within prescribed limits. The points at which the fluctuations were considered beyond the prescribed limits were correlated with the turnover rate in key personnel (e.g., the Medical Director). Though no causal relationship can be implied, sites with higher turnover rates tended to fluctuate more. The analyses suggest that SPC may be a useful tool for analyzing trends in telemedicine consultation volume fluctuations over time and, therefore, may be useful for program management and allocation of personnel resources. It can also be used in the long run to determine when and why fluctuations occur and whether the causes of fluctuations need to be addressed.

“…The Arizona Telemedicine Program (ATP) 13 began providing teleconsults in May of 1997 (May 2, 1997 was the first consult). In addition to the patients' medical records, detailed data including demographics and case turn-around times 3 are collected and analyzed.…”

Section: Methodsmentioning

confidence: 99%

Fluctuations in Service Loads in an Established Telemedicine Program

Barker²,

Beinar³

et al. 2001

The goal of this investigation was to determine if there were identifiable patterns in the volume and types of teleconsults provided by an established telemedicine program over an extended period of time. Data from over 3 years of providing telemedicine consults within a university-based telemedicine programs were analyzed to identify trends and points of significant change in service provision. Teleconsult volume over a 40-month period was best fit by a logarithmic transformation of the regression curve that is characteristic of slow but steady growth. Consults have been provided in 53 subspecialties, with an average of 12 different subspecialties each month. Number of subspecialties per month was best fit by a sixth-order polynomial. Teleconsult volume has varied on a monthly basis, but overall volume has increased over time. This program has maintained its initial goal of being a multispecialty provider. Analyzing telemedicine consult data over extended periods of time is especially useful for long-term program evaluation and development of a successful business plan.