student
Russian Federation
The article evaluates the economic impact of telemedicine on physician workload and care availability based on a stepwise implementation in 10 clinics. When 30–45% of episodes were transferred to digital channels—synchronous video visits, asynchronous question-and-answer, save-and-forward, and Remote Patient Monitoring (RPM)—throughput per physician increased by 15–22%, the median wait for an in-person visit decreased by 28–41%, and no-shows decreased by 3–8%. The total cost of an episode decreased by 10–20%, and with RPM, unplanned hospitalizations decreased by 7–10%. The breakeven point was reached at ≥18–22% of digital episodes and control over the frequency of asynchronous contacts. A clinical triage with “locks,” a balanced slot grid, and payment for a completed case ensured a sustainable effect. The effect was enhanced by task reassignment to nursing staff, quality bonuses, and causal assessment of results (stepped-wedge, difference-in-differences), including reductions in waiting lists.
telemedicine, video consultations, asynchronous calls, remote performance monitoring (RPM), throughput, accessibility of care, no-shows, cost per episode, clinical triage, pay-for-performance
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