Journal Article

Can digital communication technology reduce health system personnel time? An evaluation of personnel requirements and costs in a randomized controlled trial

Goodrich, Glenn K, Shoup, Jo Ann, Ritzwoller, Debra P, Cvietusa, Peter J, Bender, Bruce G, King, Diane K, Wagner, Nicole M, Raebel, Marsha A

2021

Overview

Abstract Use of digital communication technologies (DCT) shows promise for enhancing outcomes and efficiencies in asthma care management. However, little is known about the impact of DCT interventions on healthcare personnel requirements and costs, thus making it difficult for providers and health systems to understand the value of these interventions. This study evaluated the differences in healthcare personnel requirements and costs between usual asthma care (UC) and a DCT intervention (Breathewell) aimed at maintaining guidelines-based asthma care while reducing health care staffing requirements. We used data from a pragmatic, randomized controlled trial conducted in a large integrated health system involving 14,978 patients diagnosed with asthma. To evaluate differences in staffing requirements and cost between Breathewell and UC needed to deliver guideline-based care we used electronic health record (EHR) events, provider time tracking surveys, and invoicing. Differences in cost were reported at the patient and health system level. The Breathewell intervention significantly reduced personnel requirements with a larger percentage of participants requiring no personnel time (45% vs. 5%, p < .001) and smaller percentage of participants requiring follow-up outreach (44% vs. 68%, p < .001). Extrapolated to the total health system, cost for the Breathewell intervention was $16,278 less than usual care. The intervention became cost savings at a sample size of at least 957 patients diagnosed with asthma. At the population level, using DCT to compliment current asthma care practice presents an opportunity to reduce healthcare personnel requirements while maintaining population-based asthma control measures. A new program was implemented in a healthcare system to identify patients in need of further clinical evaluation for asthma using an automated system instead of through nurse outreach. This study identified the cost and staff requirements of this new program compared to what was normally done by the staff. We collected information from the electronic health record on patients use of the system and we asked staff to complete surveys to identify how much time they spent reaching out to patients. Almost half (45%) of patients did not need clinical evaluation reducing staff evaluation. Overall, the automated outreach program is just over $16,000 less than what is normally done. If this was done in a different health system, it would require at least 957 patients diagnosed with asthma to be cost savings. Using automated outreach can provide a way to reduce the time required of clinic staff without negatively impacting patients.

• Publisher: Oxford University Press
• Subject: Agonists / Asthma / Care and treatment / Clinical trials / Cost control / Electronic health records / Health aspects / Intervention / Medical personnel / Technology application / Telehealth & mHealth / Workforce planning