JMIR Publications

ABSTRACT

Background:

An increasing number of patients require outpatient and interventional pain management. To help meet the rising demand for anesthesia pain subspecialty care in rural and metropolitan areas, healthcare providers have utilized telemedicine for pain management of both interventional and chronic pain patients.

Objective:

We aim to describe the implementation of a telemedicine program for pain management at an academic pain division in a large metropolitan area. We also aim to estimate patient cost savings from telemedicine, before and after the California COVID-19 "Safer at Home" directive, and patient satisfaction with telemedicine for pain management care.

Methods:

This was a retrospective, observational case series study of telemedicine use in a pain division at an urban academic medical center. From August 2019 to June 2020, we evaluated 1398 patients and conducted 2948 video visits for remote pain management care. We utilize publicly available IRS Statistics of Income data to estimate hourly earnings by zip code in order to estimate patient cost savings. We estimate median travel time and travel distance with Google Maps' Distance Matrix API, direct cost of travel with median value for regular fuel cost in California, and time-based opportunity savings from estimated hourly earnings and roundtrip time. We report patient satisfaction scores derived from a post-visit satisfaction survey containing questions with five-point Likert scale responses.

Results:

Telemedicine patients avoided an estimated median roundtrip driving distance of 26 miles and a median travel time of 69 minutes during afternoon traffic conditions. Within sample, the median hourly earnings was $28/hr. Patients saved a median of $22 on gas and parking and a total of $52 per telemedicine visit based on estimated hourly earnings and travel time. Patients evaluated serially with telemedicine for medication management saved a median of $156 over three visits. 91% of patients surveyed [286/313] were satisfied with their telemedicine experience.

Conclusions:

Telemedicine use for pain management reduced travel distance, travel time, and travel and time-based opportunity costs for pain patients. We achieved the successful implementation of telemedicine across a pain division in an urban academic medical center with high patient satisfaction and patient cost savings.