An analysis on advanced practice providers delivering primary care services through telehealth

Abstract

Health care is a rapidly evolving industry with new technologies constantly entering the marketplace. Supply for quality care has to continuously catch up to demand. The United States’ primary care system is at a crossroads, as patients rightly demand the best in health care costs, access, and quality. How will the industry continue to deliver high quality of care with our nation’s increasing demands? What technologies can be best utilized when caring for our aging population? This thesis is built around key sections that address our country’s impending physician shortage and how our health care system can combat growing demand with better processes and technologies. First, this thesis will examine physician shortages in America and what opportunities are available to address the problem. Existing health care research has found that advanced practice providers improve the costs, access, and quality of care as a solution to the impending shortage. This review will also assess the effectiveness of advanced care providers and health systems using telehealth, and how technology can alleviate the primary care physician shortage. An analysis was also conducted to document the United States’ current ratio of physician to patients in each state, which shows that adding advanced primary care providers and telehealth services can narrow the gap between supply and demand in most states. Second, this thesis will analyze the impact of telehealth in the U.S. health care system. A literature review of telehealth’s definition and history will give a foundation of how the technology has already changed how Americans access care, especially in rural areas. This thesis is proposing that advance practice providers can deliver primary care services using telehealth. Through the review of studies and literature, in addition to interviews with industry experts, it is suggested that there is a lack of concrete evidence with which to fully assess the economic impact of telehealth. Two of the most common economic evaluation methods are cost-utility analysis (CUA) and cost-effectiveness analysis (CEA). The main x objective of CUA, which is used especially in health technology assessment, is to estimate the ratio between the cost of a health-related intervention and the benefit it produces in terms of the number of years lived in full health by the users. In health technology assessments, the benefits are usually expressed in quality adjusted life years.1