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The Impact of Interhospital Transfers (IHTs) and How Virtual Specialists Can Help

Nearly 1.5 million patients experience interhospital transfers (IHT) in the U.S. each year.1 The decision to transfer a patient from one hospital to another is influenced by numerous factors, such as the patient’s acuity, the availability of specialized services, clinical expertise, load-leveling, and resource constraints at the referring hospital. While many transfers are absolutely necessary, especially when a life-saving procedure is required, a large percentage of these transfers could potentially be avoided simply by adding virtual specialty coverage to the hospital’s staffing model. 

Without specialists, hospitals transfer more patients

90% of U.S. hospitals lack at least one critical specialty on staff, and 50% are missing two or more. Without specialists, emergency departments and hospitalists may feel that transferring a patient with complex care needs is the best option. This always makes sense if the patient needs a procedure that cannot be provided by the referring hospital, but depending on the diagnosis, between 32.4% and 89.1% of transferred patients don’t receive a specialty procedure at the receiving hospital.1 For this group of patients, virtual specialty care could have helped prevent their transfer in the first place. 

Virtual specialists (TeleNeurologists, TeleCardiologists, Tele Infectious Disease specialists, TelePsychiatrists, etc.) can help onsite care teams assess, diagnose, and treat patients, helping local hospitals avoid the costs and risks associated with IHT. For example, a recent UC Davis health study found that pediatric critical care telemedicine consults significantly reduced IHTs from rural and community emergency departments.2 And, in a recent AmplifyMD case study, 81% of patients who received a TeleID consult were able to avoid a transfer. 

The Impact of Unnecessary Transfers

  • Disrupting continuity of care
  • Patient and family distress: emotional & financial
  • Financial implications for hospitals
  • Unnecessary risks
  • Operational challenges and staff burnout

Unnecessary hospital transfers can have far-reaching impacts on patients, families, hospitals, and the overall cost of care.

Disrupting Continuity of Care

Unnecessary hospital transfers can disrupt continuity of care, leading to fragmented patient experiences and suboptimal outcomes. According to a study published in the Journal of Hospital Medicine, fragmented care resulting from transfers is associated with increased risks of medical errors, adverse events, and patient dissatisfaction3. Such disruptions in care continuity can undermine the overall quality of healthcare delivery and erode patient trust in the healthcare system.

Patient and Family Distress: Emotional and Financial

Hospital transfers can be emotionally distressing for patients and their families, particularly when the receiving facility is far from home. Research conducted by the National Patient Advocate Foundation highlights the profound emotional and financial burdens experienced by patients and families during transfers, including feelings of anxiety, confusion, and disorientation4. Moreover, the logistical challenges associated with arranging transportation and accommodation further exacerbate the stress and financial strain on families.

Financial Implications for Hospitals

Unnecessary transfers not only impact patients and families but also impose financial burdens on referring hospitals. A report by the Healthcare Cost and Utilization Project (HCUP) found that each hospital transfer results in additional costs for both the sending and receiving facilities, including expenses related to transportation, medical staff, and administrative overhead5. These financial implications can strain hospital budgets and undermine efforts to optimize resource allocation and cost-effectiveness in healthcare delivery. Additionally, hospitals that transfer patients out lose the opportunity for appropriate reimbursement based on the patient’s acuity and potentially the opportunity for in-network follow-ups.  

Unnecessary Risks 

Transfers can expose patients to unnecessary risks and complications. A review article published in the Journal of General Internal Medicine underscores the potential for adverse clinical outcomes resulting from inappropriate transfers, including delays in treatment, medication errors, and nosocomial infections6. Such adverse events not only harm patients but also raise concerns about liability and patient safety in healthcare practice.

Operational Challenges and Staff Burnout

Hospital transfers can pose operational challenges for healthcare providers, including care coordination, communication, and resource allocation. A study conducted by the Agency for Healthcare Research and Quality (AHRQ) highlights the strain placed on hospital staff involved in managing transfers, with increased workloads and decreased job satisfaction contributing to burnout and turnover7. These operational challenges not only affect the well-being of healthcare workers but also have implications for patient care quality and organizational performance.

Virtual Specialists Can Reduce Hospital Transfers

Virtual specialists give hospitals a powerful tool to reduce unnecessary transfers and the financial burdens associated with these IHTs. Not only can virtual specialists mitigate the direct costs of transfers, but they can also help preserve potential revenue streams by retaining patients who would otherwise be transferred out. Optimizing resource allocation across health systems, minimizing unnecessary costs, and improving capacity to deliver high-quality care locally will benefit not only the patient but also the health system as a whole. 

AmplifyMD provides virtual specialty services across 15+ fields to hospitals nationwide. Learn more about how we help hospitals improve outcomes, including reducing IHTs, here.

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