AcuteCare Telemedicine Blog


Health Benefits of Medical Outsourcing

Outsourcing often carries a negative connotation as a cost-cutting measure, but can also serve as a solution for quality improvement. Relative to the healthcare industry, effective outsourcing can lead to cost reduction and improved quality of care.

As early as February 2006, the New England Journal of Medicine published an editorial by Robert Wachter, M.D., Vice-Chairman of the UCSF Department of Medicine, describing the impact of medical outsourcing. He noted that “…healthcare’s version may offer substantial advantages for patients… Outsourcing could also provide patients with access to specialized care that would otherwise be unavailable.” Particularly beneficial in emergent situations where time is of the essence; the type of ‘outsourcing’ Dr. Wachter describes leads to better patient outcomes at a reduced overall cost.

Telemedicine, the evaluation of patients via the internet using 2-way audio-visual equipment, allows ‘outsourcing’ of neurologic care to physicians within the United States (typically in urban centers or academia) who have stroke expertise. Patients with acute neurological emergencies who have no alternative treatment options can be accessed via telemedicine within 15 minutes or less. Rapid administration of tPA improves brain tissue recovery, leading to improved patient outcomes.

Management of acute stroke changed dramatically following FDA approval in 1996 of intravenous tissue plasminogen activator (tPA) for the treatment of acute stroke. The race was on to save brain tissue by administering tPA within a 3 hour therapeutic window. The sooner tPA is given, the fewer dead brain cells; in other words, “time equals brain.” Since 1996, obstacles to the utilization of tPA kept the percent of potentially treatable patients who actually got tPA at a mere 2%. The availability of neurologists to provide time specific acute stroke care has been a primary obstacle, particularly in rural hospitals.

When time equals brain, the outsourcing of stroke care is priceless. Analysis of the economic benefits of tPA use published in the Journal of the American Heart Association (2005) revealed an annual savings of $600 per treated patient. With over 600,000 new stroke patients each year, even modest increases in the use of tPA via telemedicine (e.g. increasing from 2% to 10% of eligible patients) could save over $37 million dollars annually, which, when paired with the improvement in patient care, demonstrate the indisputable benefits of outsourcing via telemedicine.


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