Implementation of outpatient telemedicine program in vascular surgery reduces patients' travel time, cost, and environmental pollutant emissions
Paquette S, and Lin JC. Implementation of outpatient telemedicine program in vascular surgery reduces patients' travel time, cost, and environmental pollutant emissions. J Vasc Surg 2018; 67(6):e133.
J Vasc Surg
Objective: The objective of this study was to analyze the impact of outpatient telemedicine services on the travel burden of vascular surgery patients with regard to distance, time, and cost as well as the emission of environmental pollutants. Methods: Retrospective analysis using the telemedicine consultation database of Virtual Vascular Clinic was designed to compare the patient's travel expenditure and environmental impact associated with telemedicine encounters vs hypothetical in-person traditional consultations. From October 2015 to October 2017, all outpatient telemedicine encounters with vascular surgery patients at our institution were included. Savings were determined by finding the difference between the travel expenditures associated with the distance between the patient's home address and service site and the expenditures associated with the distance between the patient's home address and the physician's location. The outcomes measured were travel distance saved; travel time saved; travel costs saved; reduction in fuel consumption; and reduction in emission of carbon dioxide, carbon monoxide, nitric oxide, and volatile organic compounds. Approval from the Institutional Review Board was obtained. Patients' demographics and clinical information were obtained from the Epic electronic medical records database (Epic Systems Corporation, Verona, Wisc). All data analysis was performed using Microsoft Excel 2016 software (Microsoft, Redmond, Wash). Travel distance and time data were collected using the fastest route driving directions recommended by Google Maps (Google, Mountain View, Calif). Results: During a 2-year period, 146 outpatient telemedicine encounters were reviewed among 87 unique patients (61 women and 26 men; average age, 60 ± 13 years). The average one-way distance saved by the use of telemedicine services was 15.6 ± 6.3 miles, with an average roundtrip savings of 31.2 miles. The average one-way travel time saved was 19.5 6 9.2 minutes, with an average roundtrip savings of 39 minutes. By using telemedicine services, the vascular surgery patients saved an estimated total of $456 for the outpatient telemedicine encounters. The total reduction in passenger vehicle emission of environmental pollutants, including carbon dioxide, carbon monoxide, nitric oxides, and volatile organic compounds, was 1632 kg, 42,867 g, 3160 g, and 4715 g, respectively, with a total of 194 gallons of gas saved from driving. Conclusions: Use of telemedicine services reduces the travel distance, time, and costs for vascular surgery patients. The outpatient telemedicine program also provided environmental benefit through the reduction of greenhouse gas and pollutant emissions.