Telehealth for paediatric burn patients in rural areas: a retrospective audit of activity and cost savings

Since 2005, the Western Australian paediatric burn unit has provided a statewide clinical consultancy and support service for the assessment and management of acute and rehabilitative burn patients via its telehealth service. Since then, the use of this telehealth service has steadily increased as it has become imbedded in the model of care for paediatric burn patients. Primarily, the service involves acute and long term patient reviews conducted by the metropolitan-located burn unit in contact with health practitioners, advising patients and their families who reside outside the metropolitan area thereby avoiding unnecessary transfers and inpatient bed days. A further benefit of the paediatric burn service using telehealth is more efficient use of tertiary level burn unit beds, with only those patients meeting clinical criteria for admission being transferred. Aim: To conduct a retrospective audit of avoided transfers and bed days in 2005/06–2012/13 as a result of the use of the paediatric Burns Telehealth Service and estimate their cost savings in 2012/13. Method: A retrospective chart audit identified activity, avoided unnecessary acute and scar review patient transfers, inpatient bed days and their associated avoided costs to the tertiary burn unit and patient travel funding. Results: Over the period 2005/06–2012/13 the audit identified 4,905 avoided inpatient bed days, 364 avoided acute patient transfers and 1,763 avoided follow up review transfers for a total of 1,312 paediatric burn patients as a result of this telehealth service. This paper presents the derivation of these outcomes and an estimation of their cost savings in 2012/13 of AUD 1.89 million. Conclusion: This study demonstrates avoided patient transfers, inpatient bed days and associated costs as the result of an integrated burns telehealth service.