An analysis of unsuccessful teleconsultations

Over six years, 4317 teleconsultations were scheduled in the Arizona Telemedicine Program. A total of 402 scheduled teleconsultations (9.3%) did not take place. A review showed that 254 were cancelled but eventually took place (5.9%), while 148 never took place (3.4%). The cost of a teleconsultation to the service provider was, at minimum, 228 US dollars. Telepsychiatry accounted for all the missed consultations that eventually took place, and 92% of these were from three of the six sites referring telepsychiatry patients. Pain management (23%) and psychiatry (21%) accounted for the largest proportions of teleconsultations that never took place. Telepsychiatry cases accounted for 71% of all unsuccessful consultations and accounted for only 34% of successful teleconsultations during the same period. Most missed teleconsultations had been scheduled as realtime sessions (84%). The most common reason for unsuccessful teleconsultations was that the patient did not attend (26%), followed by the patient having to be seen in person (17%). Although all referring sites had unsuccessful cases, certain sites accounted for more than others. These were sites that scheduled more telepsychiatry consultations than the others. The proportion of unsuccessful cases per site ranged from 4% to 17% of the total number of scheduled teleconsultations.