RESUMEN
This study evaluates the adoption of clinician billing for patient portal messages as e-visits, prompted by significant increases in patient messaging after the onset of the COVID-19 pandemic.
Asunto(s)
Registros Electrónicos de Salud , Honorarios y Precios , Portales del Paciente , Telemedicina , Envío de Mensajes de Texto , Humanos , Registros Electrónicos de Salud/economía , Registros Electrónicos de Salud/estadística & datos numéricos , Portales del Paciente/economía , Portales del Paciente/estadística & datos numéricos , Envío de Mensajes de Texto/economía , Envío de Mensajes de Texto/estadística & datos numéricos , Telemedicina/economía , Telemedicina/estadística & datos numéricos , Honorarios y Precios/estadística & datos numéricos , Práctica Profesional/economía , Práctica Profesional/estadística & datos numéricosRESUMEN
BACKGROUND: Telemonitoring for COVID-19 has gained much attention due to its potential in reducing morbidity, healthcare utilization, and costs. However, its benefit with regard to economic outcomes has yet to be clearly demonstrated. OBJECTIVE: To analyze the costs associated with the use of the Opal portal to monitor COVID-19 patients during their 14-day confinement in Quebec and compare them to those of non-users of any home telemonitoring technology. METHODS: A cost analysis was conducted through a cross-sectional study between COVID-19 patients who used (PU) the Opal platform during their 14-day confinement at home and those who did not use (PNU) any home remote monitoring technology. Data was collected between June 2021 to April 2022. An individual interview with each participant using an adapted questionnaire was conducted by telephone or online using a teleconferencing platform. A micro-costing approach was undertaken using a dual patient and Quebec's health-care system perspective. RESULTS: 27 telemonitoring participants, 29 non-users, 8 clinicians, and 4 managers were included. Telemonitoring reduced the average total costs incurred by PU by 82% ($537.3CAD) between PU ($117.2CAD) and PNU ($654.5CAD). Telemonitoring enrollees used healthcare less intensely with fewer emergency room visits (1 PU compared to 6 PNU), which translated to an average savings of $253.3CAD per patient. CONCLUSION: This is the first study to demonstrate that telemonitoring through the Opal platform is a viable strategy to reduce healthcare costs and utilization for patients and the healthcare system. The evidence provides strong support for introducing telemonitoring as a component of case management.