Telemed J E Health - Mobile health is worth it! Economic benefit and impact on health of a population-based mobile screening program in new Mexico.


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CKGROUND: HABITS for Life was a 3-year initiative to broadly deliver a statewide biometric and retinal screening program via a mobile unit throughout New Mexico at no charge to participants. The program goal-to identify health risk and improve population health status-was tested over a 3-year period. Value to participants and impact to the healthcare system were measured to quantify impact and value of investing in prevention at the community level.MATERIALS AND METHODS: We used the Mobile Health Map Return-on-Investment Calculator, a mobile screening unit, biometric screening, retinography, and community coordination. Our systems included satellite, DSL, and 3G connectivity, a Tanita? (Arlington Heights, IL) automated body mass index-measuring scale, the Cholestec? (Alere?, Waltham, MA) system for biomarkers and glycosylated hemoglobin, a Canon (Melville, NY) CR-1 Mark II camera, and the Picture Archiving Communication System.RESULTS: In this report for the fiscal year 2011 time frame, 6,426 individuals received biometric screening, and 5,219 received retinal screening. A 15:1 return on investment was calculated; this excluded retinal screening for the under-65 year olds, estimated at $10 million in quality-adjusted life years saved. Statistically significant improvement in health status evidenced by sequential screening included a decrease in total cholesterol level (p=0.002) (n=308) and an increase in high-density lipoprotein level after the first and second screening (p=0.02 and p=0.01, respectively), but a decrease in mean random glucose level was not statistically significant (p=0.62). Retinal results indicate 28.4% (n=1,482) with a positive/abnormal finding, of which 1.79% (n=93) required immediate referral for sight-threatening retinopathy and 27% (n=1,389) required follow-up of from 3 months to 1 year.CONCLUSIONS: Screening programs are cost-effective and provide value in preventive health efforts. Broad use of screening programs should be considered in healthcare redesign efforts. Community-based screening is an effective strategy to identify health risk, improve access, provide motivation to change health habits, and improve physical status while returning significant value.

Resumo Limpo

ckground habit life year initi broad deliv statewid biometr retin screen program via mobil unit throughout new mexico charg particip program goalto identifi health risk improv popul health statuswa test year period valu particip impact healthcar system measur quantifi impact valu invest prevent communiti levelmateri method use mobil health map returnoninvest calcul mobil screen unit biometr screen retinographi communiti coordin system includ satellit dsl g connect tanita arlington height il autom bodi mass indexmeasur scale cholestec aler waltham ma system biomark glycosyl hemoglobin canon melvill ny cr mark ii camera pictur archiv communic systemresult report fiscal year time frame individu receiv biometr screen receiv retin screen return invest calcul exclud retin screen year old estim million qualityadjust life year save statist signific improv health status evidenc sequenti screen includ decreas total cholesterol level p n increas highdens lipoprotein level first second screen p p respect decreas mean random glucos level statist signific p retin result indic n positiveabnorm find n requir immedi referr sightthreaten retinopathi n requir followup month yearconclus screen program costeffect provid valu prevent health effort broad use screen program consid healthcar redesign effort communitybas screen effect strategi identifi health risk improv access provid motiv chang health habit improv physic status return signific valu

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