Woods K et al. 2000 "Sickle cell disease telemedicine network for rural outreach."
Reference
Woods KF, Johnson JA, Kutlar A, et al. Sickle cell disease telemedicine network for rural outreach. J Telemed Telecare 2000;6(5):285-290.
Abstract
"The Medical College of Georgia (MCG) Sickle Cell Center in Augusta, Georgia, USA, provides consultation and (in some cases) primary-care services to more than 1000 patients with sickle cell disease (SCD). Three SCD telemedicine clinic sites were established in rural areas of middle and southern Georgia, based on clinical need; a fourth site had been proposed. Over a 36-month study period, 77 telemedicine SCD clinics were held. There was a mean of 6.1 (SD 2.5) encounters per clinic and 466 total encounters among 128 SCD patients. By using telemedicine, the productivity of the MCG adult sickle cell clinic increased from 1413 to 1889 encounters a year, with an increase in rural outreach activity from 271 to 745 encounters a year. This was accomplished with the addition of a single physician assistant during the last 12 months of the study period; otherwise provider staffing was unchanged. A formal cost-benefit analysis now needs to be carried out."
Objective
"To evaluate the productivity and efficiency of sickle cell disease telemedicine network."
Type Clinic
Primary care and specialty care
Type Specific
Sickle cell disease care
Size
Small, medium and large
Geography
Rural
Other Information
Sickle cell disease clinic sites teleconsult with the Medical College of Georgia Sickle Cell Centre, with more than 1,000 patients with sickle cell disease.
Type of Health IT
Telemedicine
Workflow-Related Findings
"A total of 120 SCD patients were surveyed using the CSQ-8 patient satisfaction questionnaire. This included 60 patients who attended the SCD telemedicine clinics and 60 patients who attended standard clinics. The mean CSQ-8 scores fot both telemedicine and standard encounters was high and there were no statistical differences."
"During the study period, there was a progressive increase in the overall clinical productivity of the MCG adult SCD programme. The total number of clinical encounters increased by 34% (from 1413 to 1889 encounters a year) from 1996 (the 12 months before the implementation of telemedicine) to 1999. While clinical activity at the MCG clinic in Augusta remained stable, outreach activities increased by 175%. The expansion of outreach was accomplished by the addition of five new adult SCD clinics in distant target areas. Overall, rural outreach efforts increased to 39% (from 19%) of total clinical activity of the adult SCD programme."
"The number of encounters per clinic gradually increased over time. Overall there was a mean of 6.1 encounters per clinic (SD 2.5, range 1-4) the mean encounter time was 13.3 min (SD 6.3) and the telemedicine clinic compliance rate (i.e. the proportion of the patients scheduled to attend a clinic who actually did so) was 62%. This was higher than the compliance rate for standard encounters at the adult SCD clinic in Augusta (48%). Most patients had between one and five telemedicine encounters (mean 3.6) during the study period."
"During the study period, there was a progressive increase in the overall clinical productivity in the adult SCD program. While clinical activity at the MCG clinic remained stable, outreach activities increased by 175%. The number of physicians remained constant, but a physician assistant was hired during then last 12 months of the study period."
Study Design
Only postintervention (no control group)
Study Participants
During the 36-month study period, there were 77 sickle cell disease telemedicine clinics and 128 patients at three clinical sites.