Transaction Cost Analysis of In-Clinic Versus Telehealth Consultations for Chronic Pain: Preliminary Evidence for Rapid and Affordable Access to Interdisciplinary Collaborative Consultation

摘要: Objectives With ever increasing mandates to reduce costs and increase the quality of pain management, health care institutions are faced with challenge adopting innovative technologies shifting workflows provide value-based care. Transaction cost economic analysis can comparative evaluation consequences these changes in delivery The aim this study was establish proof-of-concept using transaction examine chronic management in-clinic through telehealth. Methods Participating providers were asked identify describe two comparable completed transactions for patients pain: one consultation between patient specialist other a telehealth presentation patient's case by primary provider team medicine specialists. Each on-site interviews. Focus on time, value labor per transaction. Number steps, identified. Results Forty-six discrete steps taken transaction, 27 Although similar ($332.89 vs. $376.48 telehealth), accrued over 153 business days 4 telehealth. Time elapsed referral completion initial 72 in-clinic, telehealth. Conclusions U.S. is moving toward use more practices, information provided analyses will be important determine actual savings benefits. © 2015 Wiley Periodicals, Inc.