P1031 - Updated Review and Two-Year Analysis of the Pacific Asynchronous Telehealth System Impact on Military Pediatric Teleconsultations

Objective
The Pacific Asynchronous TeleHealth (PATH) system is an asynchronous provider-to-provider teleconsultation platform utilized by military medical facilities throughout the Western Pacific Region. This study focused on the growth of PATH utilization for pediatric cases, impact on transfer frequency to a tertiary medical center for evaluation, and cost avoidance for the Department of Defense through utilization of this teleconsultation platform.
Methods
This retrospective analysis reviewed cases from March 2017-February 2020 for patients 0-18 years old. Two survey questions included at the time of case closure asked the referring user about the impact on travel for in-person specialty care or the need for local referral. Data for cost avoidance was estimated using established per diem rates and flights for fiscal year 2020.
Results
A total of 2448 pediatric consultations were submitted from 29 military medical facilities in 5 countries. General Pediatricians submitted 56.6% of consult requests (n=1376) and patients aged 36 months – 12 years composed the highest proportion of consults (n=1268; 51.8 %). Pediatric Pulmonology, Pediatric Cardiology, and Pediatric Neurology had the highest percentage of consults (n=557, 24.5%; n=446, 19.6%; and n=236, 10.37% respectively). Median response time from specialists to consults was 16 hours. There were 1025 completed survey responses (41.9%) with 710 (69.4%) coded as preventing in person visits. Pediatric Pulmonology (n=262), Pediatric Cardiology (n=195), and Pediatric Endocrinology (n=84) consultations were the most likely to prevent the need for face-to-face visits. By preventing these encounters, PATH saved approximately 2.5 million US dollars.
Conclusions
The annual use of PATH for pediatric consultations has more than doubled since 2009. This asynchronous telemedicine platform is a vital asset in locations with limited access to medical specialists, or during times when travel restrictions can impact routine access, such as during pandemics. Primary care providers can seek expert consultation virtually, avoiding travel for in-person routine specialty visits, which leads to a significant cost savings. This asynchronous model can be applied to civilian health care systems serving remote and underserved geographic locations by expanding the reach to pediatric specialists using a cost-efficient provider-to-provider teleconsultation platform.