Design of Video-Based Clinical Visits with Nurse Assistant for Chronic Diseases Management

Abstract

A new type of clinical visits-video-conferencing (VC) meeting with nurse assistance is emerging. Such virtual care services provide convenience and reduce travel burden of patients; however, it is unclear whether both patients and the healthcare organization would benefit from this service, due to the cost incurred by coordinating nurses to assist patients at home. Motivated by the Veterans Affairs (VA) Telehealth program, in this paper, we consider a healthcare organization offering both in-person and VC visits to community patients within its catchment area. Communities are characterized by distance and population density. A revenue-maximizing problem is formulated to identify the best pricing and patient diversion strategy that is also incentive compatible for patients. Our results show that under certain cost structures, both patients and the healthcare organization will be strictly better off with VC visits. The insights obtained from this work would support the design and implementation of VC visits that maximize the potential of telehealth to improve patient access.