Data Sources

Telehealth Facts

California prison officials provided roughly 9,000 telehealth consultations in 2004, saving taxpayers more than $4 million in transportation and escort costs.
Source:
"Telemedicine in California: Progress, Challenges, and Opportunities." California HealthCare Foundation, 2008.
Barriers to telehealth use include concerns about costs and return on investment, clinician resistance, lack of broadband connectivity, and interstate practice issues.

Source:
"Telemedicine in California: Progress, Challenges, and Opportunities." California HealthCare Foundation, 2008.
A Veterans Health Administration home telehealth program for vets with chronic conditions reduced hospital admissions by 19% and total bed days of care by 25%.

Source:
“Care Coordination/Home Telehealth: The Systematic Implementation of Health Informatics, Home Telehealth, and Disease Management to Support the Care of Veteran Patients with Chronic Conditions.” Telemedicine and e-Health, Dec. 2008.
A telemedicine burn patient assessment program reduced patient air transport from 100% of patients to 44% of patients.

Source:
"Telemedicine Evaluation of Acute Burns Is Accurate and Cost-Effective." The Journal of Trauma Injury, Infection and Critical Care, Aug. 2009.
A tele-evaluation program at 5 childcare centers reduced absences by 63% and let parents remain at work in 91% of cases evaluated by the program.

Source:
"Telemedicine Reduces Absence Resulting from Illness in Urban Child Care: Evaluation of an Innovation." Pediatrics, May 2005.
Telemedicine addresses the growing shortage of physicians in rural California, where 20% of all Californians live but only 9% of all physicians practice.

Source:
"About Rural—PRIME." University of California, Davis, School of Medicine, 2009.
One study estimates the complete deployment of telemedicine would save the nation $4.3 billion a year—a $511 million annual savings for California.

Source:
"Optimizing Telehealth in California: An Agenda for Today and Tomorrow." California Telemedicine and eHealth Center, 2009.
Telehealth services are offered in more than 30 medical specialties. Most common are dermatology, psychiatry, orthopedics, endocrinology, and neurology.

Source:
"Telemedicine in California: Progress, Challenges, and Opportunities." California HealthCare Foundation, 2008.
Telehealth increases access to care, improves outcomes, reduces costs, supports clinical education, improves patient support, and improves productivity.

Source:
"Optimizing Telehealth in California: An Agenda for Today and Tomorrow." California Telemedicine and eHealth Center, 2009.
Despite telehealth's benefits, it is not in common use. In 2007, only 3% of California consumers participated in a telehealth session.

Source:
"Telemedicine in California: Progress, Challenges, and Opportunities." California HealthCare Foundation, 2008.
In 2006, California voters passed Proposition 1D, which allocates $200 million to expand telehealth and medical education through the University of California.

Source:
"Telehealth and Broadband Efforts in California" California Telehealth Network, 2008.
Remote patient monitoring for heart disease, diabetes, pulmonary disease and skin disease could save an estimated $197 billion nationwide over 25 years.

Source:
"National Broadband Plan: National Purposes Update." Federal Communications Commission, 2010.
The State of California is developing the California Telehealth Network, a broadband network connecting more than 860 non-profit health care providers statewide.

Source:
"Telehealth and Broadband Efforts in California" California Telehealth Network, 2008.

What Is Telehealth

Specialty Care Safety Net Initiative

A 2003 study examined a major rural telehealth network, which provided patient monitoring and video conferencing services for 10 different types of medical, dental and behavioral health care. The study found substantive improvements in health outcomes and disease management among patients with diabetes and congestive heart failure, increased use of specialty dental care, and substantially reduced response times for psychiatric crisis evaluations. Based on the network’s outcomes, the study projected that for congestive heart failure alone, comprehensive telehealth intervention could reduce hospitalization costs nationwide from $8 billion a year to $4.2 billion a year.

Source:
"Outcomes of an Integrated Telehealth Network Demonstration Project." Telemedicine Journal and e-Health, Mar. 2003.
The Central California Teleopthalmology Network links 13 rural health clinics with the University of California, Berkeley School of Optometry, delivering retinal scan evaluations for thousands of low-income diabetic patients in California's Central Valley.

Source:
"Telemedicine in California: Progress, Challenges, and Opportunities." California HealthCare Foundation, 2008.
In 2004-05, the California Department of Corrections and Rehabilitation provided 9,100 telehealth consultations for inmates, saving taxpayers roughly $4 million in transportation and security costs.

Source:
"Telemedicine in California: Progress, Challenges, and Opportunities." California HealthCare Foundation, 2008.
A 2010 report by the Federal Communications Commission estimated that remote patient monitoring for heart disease, diabetes, pulmonary disease and skin disease could save an estimated $197 billion nationwide over 25 years.

Source:
"National Broadband Plan: National Purposes Update." Federal Communications Commission, 2010.
A 2002 study examined a Veterans Health Administration demonstration project, which featured home monitoring systems and targeted veterans with chronic conditions who were high users of costly medical services. The study compared enrollees' actual use of medical services to their projected usage if they had not taken part in the program, and also compared their actual use to veterans who were not enrolled in the program. The study found a 40% reduction in emergency room visits, a 63% reduction in hospital admissions, a 60% reduction in hospital bed days of care, a 64% reduction in VHA nursing home admissions, and an 88% reduction in nursing home bed days of care. A 2005 follow-up study on the same program, which examined enrollees with chronic heart failure, found dramatic improvements in key health indicators, hospitalization rates, and use of important heart drugs.

Sources:
"Virtually Healthy: Chronic Disease Management in the Home." Disease Management, June 2002.

"Early Outcomes of a Care Coordination-Enhanced Telehome Care Program for Elderly Veterans with Chronic Heart Failure." Telemedicine and e-Health, Feb. 2005.
A 2006 study examined Medicare beneficiaries with diabetes who enrolled in a disease management program, and compared them to beneficiaries who received conventional care. The program included live video counseling sessions and email discussions with nurse case managers, home monitoring of vital signs, with results automatically uploaded to electronic medical records, and patient education Web sites in English and Spanish. The study found that program enrollees reduced their blood sugar levels substantially below those of non-enrollees. Managing blood sugar levels as been found to prevent or substantively reduce the incidence of diabetes-related damage to the eyes, kidneys, nerves, and heart.

Source:
"A Randomized Trial Comparing Telemedicine Case Management With Usual Care In Older, Ethnically Diverse, Medically Underserved Patients With Diabetes Mellitus." Journal of the American Medical Informatics Association, Jan.-Feb. 2006.
A 2008 study examined stroke patient consultations between emergency physicians at four community hospitals and stroke specialists at a separate location. It compared patient assessments conducted by telephone with assessments conducted via a telehealth stroke consultation program, which included video conferencing and store-and-forward images of CT brain scans. More than 98% of patients in the telehealth program received correct treatment decisions, compared to 82% of patients in the telephone-only assessment. The timely use of optimal treatments can mean the difference between a stroke patient's substantial recovery, and death or long-term disability.

Source:
"Efficacy of Site-Independent Telemedicine in the STRokE DOC Trial: A Randomised, Blinded, Prospective Study.” The Lancet Neurology, Sept. 2008.
A 2007 study found that patients in a medically underserved rural area who received psychiatric services via video conference had clinical outcomes and patient satisfaction levels that were equal to patients who received face-to-face services. In addition, video conferencing services were 10% less expensive per patient than in-person services.

Source:
"Is Telepsychiatry Equivalent to Face-to-Face Psychiatry? Results From a Randomized Controlled Equivalence Trial." Psychiatric Services, June 2007.
A 1998 study evaluated a store and forward radiology demonstration project, which connected a rural hospital’s emergency department with an academic medical center. The study found no discrepancies between reviews of digital images and reviews of hard-copy X-rays, documented an average turnaround time for store and forward reviews of 1.3 hours, and reported high levels of satisfaction among emergency department physicians. It also found that reviews by academic medical center specialty radiologists led to changes in the emergency department physicians' initial diagnosis in 30% of all cases, and treatment changes in 26% of all cases.

Source:
"Effect of Real-Time Teleradiology on the Practice of the Emergency Department Physician in a Rural Setting: Initial Experience." Academic Radiology, Aug. 1998.
A 2008 study compared process times for patients with suspected skin cancer who received tele-dermatology referrals with store and forward technology versus patients who received conventional dermatology referrals. The tele-dermatology patients, on average, completed their initial consults in 4 days, compared to 48 days for conventionally referred patients; for biopsies, the wait was 38 days, versus 57 days; and for cancer removal surgery, 104 days versus 125 days. Tele-dermatology patients also had fewer dermatology clinic visits before surgery, which provided evidence of cost-effectiveness as well as quicker access to crucial medical services.

Source:
"The Impact of Store-And-Forward Teledermatology on Skin Cancer Diagnosis and Treatment." Journal of the American Academy of Dermatology, Aug. 2008.
- Merced County, a predominantly rural section of the San Joaquin Valley, is almost entirely dependent on out-of-town specialist referrals. For patients, this can mean time-consuming travel and missed appointments. A 2009 survey by University of California, Merced found that for about 80 percent of all patients who received such referrals, the number who actually followed through with appointments was less than 25 percent.
  
  Source:
  "Telemedicine Readiness Evaluation for the Central Valley." California Emerging Technology Fund/University of California, Merced, 2009.
- South Los Angeles is a diverse, low-income and medically underserved section of Los Angeles, with roughly 1.1 million residents. A 2009 survey of physician wait times by Merritt Hawkins & Associates found that in Los Angeles overall, wait times for appointments in cardiology, dermatology and orthopedics averaged 11 days, 13 days, and 12 days, respectively. A 2007 survey of health care services in South Los Angeles by The California Endowment found that wait times for cardiology were six months to one year; dermatology, six months; and orthopedics, six months to one year.
  
  Sources:
  "2009 Survey of Physician Appointment Wait Times." Merritt, Hawkins & Associates, 2009.
  
  "Critical Condition: Examining the Scope of Medical Services in South Los Angeles." The California Endowment, 2007.