GPT, which began as part of the Georgia State Insurance Office and in 2008 became a private nonprofit foundation, operates a Web-based system that allows doctors and nurses to schedule visits, and it provides marketing, education, and training on telehealth; plus the system permits providers to electronically share medical records and other data. The undertaking has been so successful that GPT is working to duplicate the program in Alabama, Florida, and other states, she says.
Once it was established, Guy explains, the statewide telehealth network helped young and old alike. In 2010, for instance, in rural Nashville, Ga., 44 children arrived at the emergency department with asthma-related illnesses. So, as of 2011, school-based telemedicine clinics were added to area schools and last year only one child landed in the hospital ED, she explains. Guy adds that 118 ED visits were avoided through the school-based clinics, saving an estimated $354,000. Children with chronic conditions may not get the specialty care needed, but through these clinics they can be routinely checked by specialists—ensuring better continuity of care while also helping parents avoid work absences.
GPT has also placed telehealth into nursing homes. In 2011, using telehealth resulted in 160 ED visits being avoided, saving approximately $480,000 in ED cost, Guy says, "In the past, these older patients may have just called for an ambulance when they had a problem. But now patients can be seen by a doctor without an expensive ambulance trip to the ED. Plus they can use it for routine access to care, and by getting that they're less likely to end up in the hospital as frequently," Guy says.
Telehealth visits saved 310 miles and nearly six hours of traveling on average, according to a study by Children's Healthcare of Atlanta, a three-hospital system for children and teens. CHA reviewed 609 appointments over a nine-month period and noted that approximately 86% of patients would have missed school and more than 80% of parents would have missed a full day of work to go to the city for an in-office visit, according to data published in the Atlanta Journal-Constitution. Additionally, Guy explains that out of the 40,009 telehealth visits GPT tracked, a random sample showed an average savings of patient travel time of 124 miles per encounter and nearly $762,027 in fuel alone.
Although Georgia has mandated that the telemedicine services be reimbursed by payers, not all states have enacted telehealth legislation. Still, some payers are moving forward on their own. Insurers such as Aetna, Cigna, UnitedHealthcare, and BlueCross and BlueShield, along with some large employers like General Electric and Delta Air Lines, are advocating the use of telemedicine as a way to make doctor visits less expensive and more easily available.