3580 What percent of unnecessary ED visits for chronic conditions can be reduced by extant telemedicine devices?

Abstract

OBJECTIVES/SPECIFIC AIMS: This study will elucidate what percent of unnecessary ED visits for chronic conditions can be reduced by extant telemedicine devices, and which telemedicine devices can yield the greatest reduction in unnecessary ED visits for chronic conditions. METHODS/STUDY POPULATION: We intend to use the Nationwide Emergency Department Sample (NEDS) to estimate the percent of ED visits, with a chronic condition as the principal diagnosis, were only evaluation and management services were rendered. The NEDS is the largest publicly available, all-payer ED database, providing national estimates of ED visits. The NEDS contains information on patient demographics, principal diagnosis (captured by ICD-9-CM codes and defined as the main reason for bringing the patient to the hospital), and procedure codes using Current Procedural Terminology, Fourth Edition (CPT-4). Patients with a chronic condition will be identified using Chronic Condition Indicator developed by the Agency for Healthcare Research and Quality and, from them, patients who only received “evaluation and management” services will be extracted using the CPT-4 codes 99281–99283 and G0380–G0383. Then using our previously developed database, wherein FDA-approved OTC medical devices were allied to chronic conditions by applying the transitive property of equality between telemedicine devices – measurement and measurement – conditions pairs, we will elucidate what percent of unnecessary ED visits for chronic conditions which can be reduced by extant telemedicine devices. RESULTS/ANTICIPATED RESULTS: We anticipate multiple OTC telemedicine devices will be necessary to evaluate and manage common principal conditions. DISCUSSION/SIGNIFICANCE OF IMPACT: Telemedicine is seen as a potentially powerful tool for improving healthcare and reducing cost. UnitedHealthcare, the largest US insurance provider, has partnered with Doctors on Demand, the largest players in the telemedicine app space, and other app-based telemedicine services to provide on-demand access to physicians. However, to reach the full potential of telemedicine, and more specifically towards reducing unnecessary ED visits for chronic conditions, telemedicine services need to include capabilities that will allow for the evaluation and management of chronic conditions. This study is a pragmatic first step towards understanding what telemedicine devices would best augment existing telemedicine services to reduce unnecessary ED utilization.