Telemedicine could be useful for nighttime patient admissions

The low number of nighttime admissions to hospitals may reveal an opportunity for leveraging telehospitalist physicians to deliver inpatient services during that time, a new study published in Telemedicine and e-Health finds.

Nighttime could be one of the most useful times to employ telemedicine, study authors argued, because "telemedicine is most effective when applied where physician resources are scarce, patient care is time sensitive and service volume may distributed across a network."

For the study, researchers analyzed the Florida state hospital discharge dataset to investigate the potential market for a nighttime telehospitalist service. They found 19 percent of common hospitalist admissions occurred between 7 p.m. and 7 a.m., with the range of admissions per night only between zero and 10 patients. Eighty percent of admissions occurred before midnight.

The study authors said that nighttime care is especially problematic for hospitalist practices offering 24/7 care. Staffing is usually reduced starting at 7 p.m., and night coverage is more expensive than day coverage because of lower volumes of billable services. Inconsistencies in the quality of nighttime vs. daytime care are unacceptable, the authors said, and therein lies the opportunity for a high-performing telemedicine service that's a viable source of patient care.

"The low volume of nighttime admissions indicates an opportunity to leverage a telehospitalist physician service to deliver inpatient medical admission services across a network," the study's authors concluded. "Lower volumes of nighttime admissions in rural facilities may indicate a market for telehospitalist solutions to address the dilemma of hospitalist staffing shortages."

Nighttime telemedicine services are inspired by telemedicine in the emergency department and the intensive care unit--in June, it was reported that the University of California-San Diego Health System has launched a telemedicine pilot program in order to help decrease emergency room wait times for patients. The program is designed to enable doctors to see patients via video when the ED becomes busy.

And in November, researchers found that telemedicine may reduce errors in rural emergency departments, according to a study published in the Annals of Internal Medicine.

To learn more:
- check out the full study (.pdf)

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