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Telemedicine in the Gulf. L o c a t I n g T e l e m e d I c I n e S I t e s I n t h e G u l f o f M e x I c o. Al Glasgow, MBA, MS

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Telemedicine in the Gulf

L o c a t I n g T e l e m e d I c I n e S I t e s I n t h e G u l f o f M e x I c o

Al Glasgow, MBA, MS

Department of Health Informatics, University Health Science Center at Houston, University of Texas, Houston, TX

Department of Geographic Information Science,

Houston Community College, Houston, TX

what is telemedicine
What is telemedicine?

The use of electronic information and communication technology to provide supportive health care when distance separates participants.

Institute of Medicine

telemedicine benefits
TELEMEDICINE BENEFITS
  • Improves survival rate
  • Improves care outcomes w/lower cost of care
  • Immediate response
  • Expands geographic coverage
  • Reduces operating costs (mainly transportation)
  • Patient satisfaction = worker retention

FASTER -- BETTER -- CHEAPER

investigation purpose
INVESTIGATION PURPOSE

To utilize GIS in developing a model for collection and analysis of large amounts of patient population data and to effectively communicate findings as part of the needs assessment process for planning telemedicine services in the Gulf.

goals
GOALS
  • Improve Patient Care Outcomes
    • Ensure timely access to health care
    • Project specialist care to remote locations
  • Improve Health Care Delivery Productivity
    • Minimize MEDEVAC’s
    • Increase worker satisfaction
  • Utilize GIS in Needs Assessment Process
    • Identify optimal strategiesfor TM deployment
strategy
STRATEGY
  • Evaluate effectiveness (MEDEVAC Avoidance)
  • Assess “fit” of initial program for expanded operation with more distant patients and propose alternate solutions.
background
BACKGROUND

20,000 Individuals engaged in high risk activities, mainly oil and gas related

Technology advances

  • High speed & volume fiber optic network = 15% to 25% operating cost reduction
  • Advanced seismic technology = increased drilling activity, especially in more distant deepwater
  • Telemedicine’s fit with economic and health care objectives
methods
METHODS
  • Collect data on target population

(Site numbers, sizes, spatial relationships)

  • Determine cost savings and number of MEDEVAC’s to breakeven
  • Develop strategies for sites beyond initial coverage area (beyond 50 miles)
tm assumptions
TM ASSUMPTIONS

Equipment Costs

TM unit costs (Lease/mon./unit) $ 500

Operating Costs

Training (Trainee/year) $ 500

Equip. maintenance (In lease) $ -0-

MEDEVAC Costs ($/Mile) $ 150

MEDEVAC Costs ($/Case) $5,000 *

Consult cost (Per case) $ 75

Return HELO trip $2,000

Credits - Avg. wage ($/Hr.) $71.69

Manhrs./MEDEVAC saved 8.0 **

Other Assumptions

MEDEVAC reduction w/TM 30%

* $3000 flat fee for trips <2.5 hrs. Rate for >2.5 hour trips is $1200/hr.

** One 8-hour day recovered per MEDEVAC avoidance.

patient distribution summary
PATIENT DISTRIBUTION SUMMARY

72% of population within 100 to 200 miles

76% of population on <=15 member crews

A widely distributed population beyond 50 miles (Mostly beyond 100 miles).

next steps
NEXT STEPS

Determine optimal hub site(s)

  • Time and cost minimization for maximum # of patients
  • Model demand for services based on analysis of risk
  • Identify sites that can accommodate TM facility
  • Consider phasing options
conclusions
CONCLUSIONS

Care Outcomes Improvement

  • Quicker response, farther reach and projection of specialty care

TM Effectiveness

  • Substantial cost savings
  • Patient satisfaction = worker retention

GIS Value

  • Visualization of demand factors to guide deployment and site selection process
acknowledgements
ACKNOWLEDGEMENTS

Kim Dunn, MD, PhD (1)

Osborne Nye, PhD (2)

Fardosht Armirphanihi (2)

Anna Zachos (3)

(1) Department of Health Informatics, School of Health

Information Sciences, Health Science Center at Houston,

University of Texas, Houston, TX

(2) Department of Geographic Information Science, Houston

Community College, Houston, TX

(3) School of Public Health, University of Texas, Houston, TX