Patient outcomes would improve--and at a much lower cost--if only the United States would embrace telemedicine, says Vijay Govindarajan, Professor of International Business at the Tuck School of Business at Dartmouth College.
Govindarajan, writing in a recent Harvard Business Review blog post, points to a recent study of telemedicine at Lazarus Hospital in India that adopted telemedicine to treat patients with end stage renal disease (ESRD). For their rural patients, the hospital opted to use peritoneal dialysis (PD), which is performed in patients' homes, rather than the more expensive hemodialysis (HD), which is provided at the hospital and which requires the patients to travel for treatment.
Using telemedicine tools such as cameras, remote monitoring and online reporting, the PD patients had better survival rates than their urban counterparts. The hospital also cut the costs of treatment 90 percent, from $170,000 to about $12,000 per patient.
Govindarajan recommended that U.S. providers use PD with remote telemonitoring as it is less cumbersome, less expensive and improves quality of life. But he noted that more than 90 percent of patients receive HD despite the higher cost and inefficiency, and blamed it on the American approach to healthcare.
The blame, he says, is on the American approach to care: physicians get better reimbursement for HD than PD, for example.
It has been established that the cost of healthcare in the United States is higher than in other countries, in large part due to the reimbursement structure, which shapes decision-making. That may be one reason why telemedicine, which can keep costs down, but is largely not reimbursable in the United States, is arguably making better headway in other countries.