Impact of Telemedicine on Healthcare Service System Considering Patients’ Choice

Telemedicine is an effective way to alleviate the congestion of hospitals and improve the utilization of medical resources. In this paper, we develop a stylized queue model to study whether the hospital should adopt telemedicine service and in which form (the gatekeeper system or dual-channel service system) the hospital should provide telemedicine service. Patients’ delay sensitivity and transportation cost are also considered in our model. Our main results follow. First, in most cases, telemedicine service can help to reduce the total cost of the healthcare system, and patients treated online or offline can both benefit from the adoption of telemedicine. Second, the dual-channel healthcare system is more flexible than the traditional outpatient system and the gatekeeper system. There exists an optimal market segmentation of the two channels in the dual-channel healthcare system. Finally, we find that the hospital should implement the telemedicine when the transportation cost is high or patients have a large gap between online and offline waiting sensitivity.

[1]  M. B. Alkmim,et al.  Improving patient access to specialized health care: the Telehealth Network of Minas Gerais, Brazil. , 2012, Bulletin of the World Health Organization.

[2]  Yu Han,et al.  Evaluating the Effectiveness, Efficiency and Safety of Telemedicine for Urological Care in the Male Prisoner Population , 2018, Urology practice.

[3]  Xuanming Su,et al.  Omnichannel Service Operations with Online and Offline Self-Order Technologies , 2018, Manag. Sci..

[4]  Abraham Seidmann,et al.  Service Systems with Heterogeneous Customers: Investigating the Effect of Telemedicine on Chronic Care , 2019, Manag. Sci..

[5]  J. Kokesh,et al.  Preoperative planning for ear surgery using store-and-forward telemedicine , 2010, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[6]  Zeinab Salehahmadi,et al.  Telemedicine in Iran: Chances and Challenges , 2013, World journal of plastic surgery.

[7]  Bernard Kamsu-Foguem,et al.  Modeling for effective collaboration in telemedicine , 2015, Telematics Informatics.

[8]  S. Spector,et al.  Telemedicine broadening access to care for complex cases. , 2017, The Journal of surgical research.

[9]  Global geriatric evaluation is feasible during interactive telemedicine in nursing homes , 2017 .

[10]  Hamid A. Jalab,et al.  Discrete Dynamics in Nature and Society 3 By employing the Cauchy formula for iterated integrals yields , 2014 .

[11]  Robin Lindsey,et al.  Comparison of Subsidy Schemes for Reducing Waiting Times in Healthcare Systems , 2017 .

[12]  Beth L. Kreofsky,et al.  Emergency Video Telemedicine Consultation for Newborn Resuscitations: The Mayo Clinic Experience. , 2016, Mayo Clinic proceedings.

[13]  Hong Wu,et al.  Online written consultation, telephone consultation and offline appointment: An examination of the channel effect in online health communities , 2017, Int. J. Medical Informatics.

[14]  Hao Zhang,et al.  Contract Design by Service Providers with Private Effort , 2017, Manag. Sci..

[15]  Qiang Wan,et al.  Choosing among hospitals in the subsidized health insurance system of China: A sequential game approach , 2017, Eur. J. Oper. Res..

[16]  Christian Kolbitsch,et al.  A cost comparison of telepathology and a visiting pathologist service , 2003, Journal of telemedicine and telecare.

[17]  Rafay Ishfaq,et al.  Bridging the Healthcare Access Divide: A Strategic Planning Model for Rural Telemedicine Network , 2015, Decis. Sci..

[18]  Michelle Brear,et al.  Evaluating Telemedicine: Lessons and Challenges , 2006, Health information management : journal of the Health Information Management Association of Australia.

[19]  Bin Shen,et al.  Service supply chain management: A review of operational models , 2015, Eur. J. Oper. Res..

[20]  Uday S. Karmarkar,et al.  Contracting for Collaborative Services , 2008, Manag. Sci..

[21]  P. Cuijpers,et al.  Improving the cost-effectiveness of a healthcare system for depressive disorders by implementing telemedicine: a health economic modeling study. , 2014, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[22]  A. Drago,et al.  Videoconferencing in psychiatry, a meta-analysis of assessment and treatment , 2016, European Psychiatry.

[23]  Jahidul Hasan.  Effective telemedicine project in Bangladesh: Special focus on diabetes health care delivery in a tertiary care in Bangladesh , 2012, Telematics Informatics.

[24]  Jai Ganesh Udayasankaran,et al.  The impact of telemedicine in the post-operative care of the neurosurgery patient in an outpatient clinic: A Unique perspective of non-exigent utilization of this valuable resource in the developing world, an experience of over 3000 tele-consultations , 2014 .

[25]  Cristina Masella,et al.  Telemedicine services: How to make them last over time , 2017 .

[26]  Jie Song,et al.  Patient admission control in a hierarchical healthcare system , 2017 .

[27]  C. Nelson,et al.  Impact of store-and-forward (SAF) teledermatology on outpatient dermatologic care: A prospective study in an underserved urban primary care setting. , 2016, Journal of the American Academy of Dermatology.

[28]  Paul A Scuffham,et al.  A cost minimisation analysis of a telepaediatric otolaryngology service , 2008, BMC health services research.

[29]  Edieal J. Pinker,et al.  Outsourcing a Two-Level Service Process , 2012, Manag. Sci..

[30]  Zhongsheng Hua,et al.  Competition and Coordination in Two‐tier Public Service Systems Under Government Fiscal Policy , 2016 .

[31]  Shailesh Kulkarni,et al.  The impact of wearable devices and performance payments on health outcomes , 2018, International Journal of Production Economics.

[32]  Anthony C. Smith,et al.  A systematic review of the methodologies used to evaluate telemedicine service initiatives in hospital facilities , 2017, Int. J. Medical Informatics.

[33]  Wallace J. Hopp,et al.  Workload Management in Telemedical Physician Triage and Other Knowledge-Based Service Systems , 2017, Manag. Sci..

[34]  J. Kvedar,et al.  Telemedicine in the future , 2005, Journal of telemedicine and telecare.

[35]  Clareci Silva Cardoso,et al.  Implementation of a telecardiology system in the state of Minas Gerais: the Minas Telecardio Project. , 2010, Arquivos brasileiros de cardiologia.

[36]  Hsing Luh,et al.  Characterizing output processes of Em/Ek/1 queues , 2006, Math. Comput. Model..

[37]  B. Dan,et al.  Pricing policies in a dual-channel supply chain with retail services , 2012 .

[38]  Chinmay Chakraborty,et al.  A review on telemedicine-based WBAN framework for patient monitoring. , 2013, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[39]  Weifen Zhuang,et al.  Tax/subsidy and capacity decisions in a two-tier health system with welfare redistributive objective , 2017, Eur. J. Oper. Res..

[40]  Özalp Özer,et al.  Dual Sales Channel Management with Service Competition , 2008, Manuf. Serv. Oper. Manag..

[41]  Jason Roy,et al.  Acute illness utilization patterns before and after telemedicine in childcare for inner-city children: a cohort study. , 2007, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[42]  Edieal J. Pinker,et al.  Gatekeepers and Referrals in Services , 2003, Manag. Sci..

[43]  Xiaoqiang Cai,et al.  Mutual referral policy for coordinating health care systems of different scales , 2015 .

[44]  Yi-Lwun Ho,et al.  Assessment of the Cost-Effectiveness and Clinical Outcomes of a Fourth-Generation Synchronous Telehealth Program for the Management of Chronic Cardiovascular Disease , 2014, Journal of medical Internet research.

[45]  Zafer D. Özdemir,et al.  On the staffing policy and technology investment in a specialty hospital offering telemedicine , 2009, Decis. Support Syst..