title: VA Telemedicine: An Analysis of Cost and Time Savings.
abstract: BACKGROUND
  The Veterans Affairs (VA) healthcare system provides beneficiary travel reimbursement ("travel pay") to qualifying patients for traveling to appointments. Travel pay is a large expense for the VA and hence the U.S. Government, projected to cost nearly $1 billion in 2015. Telemedicine in the VA system has the potential to save money by reducing patient travel and thus the amount of travel pay disbursed. In this study, we quantify this savings and also report trends in VA telemedicine volumes over time.
  
  
  METHODS
  All telemedicine visits based at the VA Hospital in White River Junction, VT between 2005 and 2013 were reviewed (5,695 visits). Travel distance and time saved as a result of telemedicine were calculated. Clinical volume in the mental health department, which has had the longest participation in telemedicine, was analyzed.
  
  
  RESULTS
  Telemedicine resulted in an average travel savings of 145 miles and 142 min per visit. This led to an average travel payment savings of $18,555 per year. Telemedicine volume grew significantly over the study period such that by the final year the travel pay savings had increased to $63,804, or about 3.5% of the total travel pay disbursement for that year. The number of mental health telemedicine visits rose over the study period but remained small relative to the number of face-to-face visits. A higher proportion of telemedicine visits involved new patients.
  
  
  CONCLUSIONS
  Telemedicine at the VA saves travel distance and time, although the reduction in travel payments remains modest at current telemedicine volumes.
authors: 1 Dartmouth-Hitchcock Medical Center , Lebanon , New Hampshire.
authors: Jack E
authors: JE
authors: Russo
authors: 2 Section of Otolaryngology, Department of Surgery, Department of Veterans Affairs Medical Center , White River Junction, Vermont.|3 Section of Otolaryngology, Geisel School of Medicine at Dartmouth , Hanover, New Hampshire.
authors: Ryan R
authors: RR
authors: McCool
authors: 1 Dartmouth-Hitchcock Medical Center , Lebanon , New Hampshire.|2 Section of Otolaryngology, Department of Surgery, Department of Veterans Affairs Medical Center , White River Junction, Vermont.|3 Section of Otolaryngology, Geisel School of Medicine at Dartmouth , Hanover, New Hampshire.|4 VA Outcomes Group, Department of Veterans Affairs Medical Center , White River Junction, Vermont.|5 The Dartmouth Institute for Health Policy and Clinical Practice , Hanover, New Hampshire.
authors: Louise
authors: L
authors: Davies
mesh_terms: D000328:Adult; D000368:Aged; D017046:Cost Savings; D005260:Female; D006297:Health Services Accessibility / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D017060:Patient Satisfaction; D012189:Retrospective Studies; D019035:Rural Health Services / Q000458:organization & administration; D017216:Telemedicine / Q000191:economics* / Q000706:statistics & numerical data*; D013997:Time Factors; D014195:Travel / Q000191:economics; D014481:United States; D014493:United States Department of Veterans Affairs; D058014:Veterans Health
keywords: beneficiary travel; cost savings; distance; telemedicine; time; travel