Return on Investment (ROI) on telemedicine programs is today’s “needle in a haystack.”

Often the closest that we can come to real money is cost-effectiveness.  A new report by the Mayo Clinic suggests that telestroke programs, like the ones it operates, are “cost-effective” for rural hospitals that don’t have the specialty.  The research is in the latest issue of Circulation: Cardiovascular Quality and Outcomes.  Other studies have already shown that they are cost-effective in terms of preserving patients’ quality of life even though the costs and benefits from the small hospitals in the stroke networks have never been fleshed out.

Some skeptics in medicine have perpetuated a myth that a telestroke network becomes a financial burden for a hospital.  However, the Mayo study revealed a telestroke program was likely to save the hospital money while improving patient outcomes and discharging them sooner.  Even if telestroke coverage costs a hospital a couple thousand dollars more to save a patient’s quality of life, Dr. Bart Demaerschalk at Mayo says, “It’s a bargain really.”

A story about the study, titled “Telestroke is Cost-Effective for Hospitals, Mayo Clinic Researchers Show, is available on the Mayo Clinic Web site.

Here’s where the ROI comes in.  Data supplied by the Mayo Clinic and the Georgia Health Sciences University indicate that a small hospital with a telestroke program can treat 45 more patients every year with clot-busting drugs and 20 more with endovascular stroke therapies.  According to the study, this represents more than $100,000 in cost savings each year.  If reimbursement opportunities increase, the hospitals might save even more money.  Dermaerschalk says, “The upfront costs associated with setting up the telestroke technology and managing the network organization are quickly offset by the financial gains that result from a higher proportion of patients receiving clot busting drugs and the reduced stroke-related disability and subsequent reduced need for rehabilitation, nursing home care and assistance at home.”

When it comes to a telestroke program, the small hospitals on the patient end benefit economically.  The study suggests that the spoke hospitals that enjoy this increase in revenues should share them and help finance the telestroke network system.

Telestroke programs are the easiest to justify among telemedicine programs because with them outcomes can be so dramatically better.  Since the American Academy of Neurologists says that 45% of Americans live 60 minutes away from the nearest specialist, providing greater access to that higher level of healthcare is essential in preserving a patient’s independence.  Most stroke victims who don’t get clot-busting drugs are incapacitated; many live on for decades in nursing homes unable to care for themselves.  Like the old Fram oil filter commercials: you can pay me now, or you can pay me (a lot more) later.