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A hospital-based asynchronous ENT telehealth service for children with otitis media: Cost-minimisation and improved
Ali Ah Altamimi1,2,3, Christopher G Brennan-Jones1,2,4,5, Monique Robinson1
1Telethon Kids Institute, The University of Western Australia, Perth, Western Australia.
Insights
A new ear, nose, and throat (ENT) telehealth service, the Ear Portal, significantly reduces healthcare costs and waiting times for children with otitis media. This asynchronous service provides specialist care faster and more affordably than traditional methods.
Area of Science:
- Telemedicine and Digital Health
- Pediatric Otolaryngology
- Health Services Research
Background:
- Otitis media is a common childhood condition requiring timely specialist care.
- Traditional ear, nose, and throat (ENT) referral pathways often involve long waiting times.
- Improving access and reducing costs in pediatric ENT care are significant healthcare challenges.
Purpose of the Study:
- To evaluate the effectiveness of a hospital-based asynchronous ENT telehealth service, the Ear Portal.
- To assess the impact of the Ear Portal on healthcare costs for treating pediatric otitis media.
- To determine if the Ear Portal improves access to care within recommended timeframes.
Main Methods:
- A prospective study involving children referred to an ENT service.
- Utilized an asynchronous telehealth platform (Ear Portal) for assessments and multidisciplinary team review.
- Conducted a cost-minimization analysis comparing the Ear Portal to standard care pathways.
- Calculated waiting times for semi-urgent (Category 2) and non-urgent (Category 3) referrals.
Main Results:
- The Ear Portal demonstrated lower running costs per appointment ($67.70 initial, $37.34 follow-up) compared to standard care ($154.65 initial, $86.10 follow-up).
- The initial investment in the Ear Portal was recouped after 223 appointments.
- Median waiting time to care plan delivery via Ear Portal was under 30 days, significantly shorter than standard care (291 days for Cat 2, 371 days for Cat 3).
Conclusions:
- The Ear Portal effectively reduces marginal costs per patient for the healthcare system.
- This asynchronous telehealth service provides timely ENT specialist care within recommended clinical timeframes.
- The Ear Portal represents a cost-effective and accessible solution for pediatric otitis media management.
Abstract:
AimThe purpose of this study is to explore the effectiveness of a hospital-based asynchronous ear, nose, and throat (ENT) telehealth service (the Ear Portal) in reducing cost and improving access for children with otitis media.MethodsParticipants were recruited to the Ear Portal from a tertiary hospital ENT waiting list. Ear and hearing assessments were conducted during appointments by the Ear Portal research assistant, and data was stored for an asynchronous review by the Ear Portal multidisciplinary team. A cost-minimisation analysis was conducted for the Ear Portal and the standard care pathways. Waiting times to provide care for both pathways were calculated for children with semi-urgent (i.e. Category 2) and non-urgent (i.e. Category 3) referrals.ResultsThe running cost for the Ear Portal was $67.70 for initial appointments and $37.34 for follow-up appointments. Conversely, the running cost for the standard care pathway was $154.65 for initial appointments and $86.10 for follow-up appointments. A total of 223 appointments were required to offset the initial Ear Portal investment of $19,384.00. The median waiting time for the Ear Portal from initial contact to care plan delivery was <30 days, whereas the median waiting times for children in the standard care pathway were 291 days (interquartile range (IQR) = 117) for Category 2 and 371 days (IQR = 311) for Category 3 referrals.ConclusionUnder the current circumstances, the Ear Portal service can reduce costs for the health care system by reducing marginal costs per patient in addition to providing ENT specialist care within the clinically recommended timeframes.
