Costs of Multidisciplinary Parenteral Nutrition Care Provided at a Distance via Mobile Tablets

Abstract

Background Determining the costs of healthcare delivery is a key step for providing efficient nutrition-based care. This analysis tabulates the costs of delivering home parenteral nutrition (HPN) interventions and clinical assessments through encrypted mobile technologies to increase patients’ access to healthcare providers, reduce their travel expenses, and allow early detection of infection and other complications. Methods A traditional cost-accounting method was used to tabulate all expenses related to mobile distance HPN clinic appointments, including (1) personnel time of multidisciplinary healthcare professionals, (2) supply of HPN intervention materials, and (3) equipment, connection, and delivery expenses. Results A total of 20 mobile distance clinic appointments were conducted for an average of 56 minutes each with 45 patients who required HPN infusion care. The initial setup costs included mobile tablet devices, 4G data plans, and personnel's time as well as intervention materials. The initial costs were on average $916.64 per patient, while the follow-up clinic appointments required $361.63 a month, with these costs continuing to decline as the equipment was used by multiple patients more frequently over time. Patients reported high levels of satisfaction with cost savings in travel expenses and rated the quality of care comparable to traditional in-person examinations. Conclusion This study provides important aspects of the initial cost tabulation for visual assessment for HPN appointments. These findings will be used to generate a decision algorithm for scheduling mobile distance clinic appointments intermittent with in-person visits to determine how to lower costs of nutrition assessments. To maximize the cost benefits, clinical trials must continue to collect clinical outcomes.

What drives attitude towards telemedicine among families of pediatric patients? A survey

“…Tablets have been widely used for telemedical purposes, targeting both health care professionals [34–37] and patients [38–40]. …”

A Clinical Trail of Translation of Evidence Based Interventions to Mobile Tablets and Illness Specific Internet Sites

“…The costs for setting up mobile videoconferencing sessions can be offset by saving out-of-pocket travel costs and travel time [81], as well as providing the opportunity for the health professionals to meet with the whole family [82]. Previous research found the average out-of-pocket health care costs for these patients was $17,000 annually with travel to local and distant specialists [83].…”

Telemedicine Support Groups for Home Parenteral Nutrition Users

“…The research framework guiding the 2 trials was the family home care model 38 . The 2‐pronged intervention in each trial translates evidence‐based strategies to (1) deliver synchronous facilitated support group videoconferencing sessions via the tablets (eg, iPad mini) and (2) upload the asynchronous IVhomeCare interventions (eg, written information, forms, illustrations, and graphics) to the mobile device Internet links 39 , 40 …”

“…The average cost per iCare participant for 3 iPad visits based on equipment and mailing, connection, and personnel costs was $376. Detailed costs for the tablet visual meetings were published in the Journal of Parenteral and Enteral Nutrition 40 and were similar per visit.…”