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The value of provider-to-provider telehealth.

Telemed J E Health. 2008 Jun;14(5):446-53 Pan E, Cusack C, Hook J, Vincent A, Kaelber DC, Bates DW, Middleton B. Division of General Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachussetts, USA.

Telehealth has great potential to improve access to care, but its adoption in routine healthcare has been slow. The lack of clarity about the value of telehealth implementations has been one reason cited for this slow adoption. The Center for Information Technology Leadership has examined the value of telehealth encounters in which there is a provider both with the patient and at a distance from the patient.

We considered three models of telehealth: store-and-forward, real-time video, and hybrid systems. Evidence from the literature was extrapolated using a computer simulation, which found that the hybrid model was the most cost effective. The simulation predicted savings of $4.3 billion per year if hybrid telehealth systems were implemented in emergency rooms, prisons, nursing home facilities, and physician offices across the United States.

We also conducted a sensitivity analysis to determine which factors most influence costs and savings. Payers, providers, and policymakers should work together to remove the barriers to the adoption of telehealth so that this cost savings can be realized in the U.S. healthcare system.

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