JMIR Publications

ABSTRACT

Background:

Telehealth represents an opportunity for Australia to harness the power of technology to redesign the way healthcare is delivered. The potential benefits of telehealth include increased accessibility to care, productivity gains for health providers and patients through reduced travel, potential for cost savings, and an opportunity to develop culturally appropriate services that are more sensitive to the needs of special populations. Uptake of telehealth has been hindered at times by clinician reluctance and policies which preclude metropolitan populations from accessing telehealth services.

Objective:

To investigate if telehealth reduces health system costs compared to traditional service models, and secondly to identify the scenarios in which cost savings can be realised.

Methods:

A scoping review was undertaken to meet the study aims. Initially, literature searches were conducted using broad terms for telehealth and economics to identify economic evaluation literature in telehealth. Then, the investigators conducted an expert focus group to identify domains where telehealth could reduce health system costs, followed by targeted literature searches for corresponding evidence.

Results:

The cost analyses reviewed provided evidence that telehealth reduced costs when health system funded travel was prevented, and when telehealth mitigated the need for expensive procedural or specialist follow-up by providing competent care in a more efficient way. The expert focus group identified four areas of potential savings from telehealth; productivity gains, reductions in secondary care, alternate funding models and telementoring. Telehealth demonstrated great potential for productivity gains arising from health system redesign, however under the Australian activity based funding it is unlikely that these gains will result in cost savings. Secondary care use mitigation is an area of promise for telehealth, however many studies did not demonstrate overall cost savings due to the cost of the administering and monitoring the telehealth systems. Alternate funding models from telehealth systems have the potential to save the health system money in situations where the consumers pay out of pocket to receive services. Telementoring has had minimal economic evaluation, however long-term represents an inadvertently result in cost savings by upskilling generalist clinicians and allied health.

Conclusions:

Health services considering implementing telehealth should be motivated by benefits other than cost reduction. The available evidence has indicated that while telehealth provides overwhelmingly positive patient benefits, and increases productivity for many services current evidence suggests that it does not routinely reduce the cost of care delivery for the health system. Clinical Trial: Not applicable