JMIR Publications

ABSTRACT

Background:

Video-conferencing is a disruptive modality that challenges the traditional model of having a clinician or patient physically present for an appointment. The novelty is that it offers the opportunity to redesign service models. For instance a virtual consultation can provide video-conference consultations while being located anywhere in the world that has internet. A virtual consultant also obviates the issues of attracting a specialist medical workforce to rural areas, and allow the rural health service to control the specialist services that they offer.

Objective:

This research aims to evaluate the economic effects on rural and metropolitan sites for each of the three different models of care. The models of care being examined are patient travel, telehealth using video-conferencing, and rural site virtual health worker.

Methods:

Using retrospective activity data for three years a return on investment (ROI) analysis was undertaken from the perspective of the rural site and metropolitan partner site using a teleorthopedic fracture clinic as an example. Further analysis was conducted to calculate how many patients would be required to attend the clinic for each model of care for the site to break-even with regard to cost.

Results:

The only service model that resulted in a positive ROI for the rural site over the three year period was the virtual consultant model. The break-even analysis demonstrated that the rural site required the lowest number of patients to recoup costs in the virtual health worker model of care. However, they were unable to recoup their costs within the travel model due to the cost of travel and lack of income opportunity.

Conclusions:

Our model demonstrated that rural health care providers could increase their ROI if they employ a virtual health worker.