Slice of the pie: Results of telehealth benchmarking survey

This is the second 2002 installment on the results of the TeleHealthSurvey(C) endorsed by AAACN. Since last year, we have been presenting one data point (or "slice") from the survey at a time in Viewpoint, concentrating on the points we feel are of most interest to readers. This survey, which is in its third year, is sponsored by HMS Northwest Inc. Results from the past 2 years are already starting to show a trend in industry data.

The survey is available on-line by going to www.hmsnorthwest.com and clicking on the link to the TeleHealthSurvey(C) 2002. In 2000, 67 organizations registered and over 30% participated. In 2001, there were 65 registered organizations.

A report, 2000-2001 Charter Edition, which compares the results of those first years, is available for general sales at the discounted rate of $99. Ten percent of the gross profits will be donated to the AAACN Telehealth Nursing. Practice Special Interest Group. Additional discounts for registrants and participants to the survey data also apply. For more information contact Cartwright.Julie@hmsnorthwest.com.

The survey is intended to be a continuous process in collecting benchmarks from the telehealth industry. This includes any organization that provides telephone triage, physician referral, appointment scheduling or health plan contact center services. The survey also includes physician office nurses and support. Annual updates are planned, and the 2002 edition is available for data input until December 31, 2002. If you would like to suggest survey questions for future publication in Viewpoint, please e-mail Julie Cartwright at the address cited earlier.

Data Query: Budget Expenditures

What can we learn about the industry by looking at budgetary expenditures? How budgetary items are aligned say a lot about the focus and values of a program. We all know that salary and benefits will account for the biggest chunk of the budget. The TeleHealthSurvey(C) highlights two other significant areas:

* Growth and development of the program resources (telecommunications, computer hardware and software, facilities, etc)

* Growth and development of the human resources (orientation and training, ongoing education, recruiting, CQI/QA). The latter is a significant indicator of the ability to manage change. Let's look at how the responses fared.

Results

In 2000, survey participants reported that expenses for human resources were 84% (57% wages, 16% benefits). The 2001 respondents reported expenses at 90% (70% wages, 21% benefits), with more spent in both areas than in 2000. It is interesting to note that while both areas increased, wages in 2001 took the biggest leap. Overall an increase of 6% (from 84% in 2000 to 90% in 2001) is less significant, however a difference of 13% for wages alone is more meaningful. Based on other input, we could speculate that the 13% increase in wages might be due to variances in staffing mix, geographic location, and size of the operation. The 4% increase in benefits hopefully supports the value of health care employees in the workplace, as an increase in benefits money can indicate long-term value toward retention and tenure, while wages support short-term employment goals. Now let's take a closer look.

1. Growth and Development of the Program Resources (telecommunications, computer hardware and software, facilities, etc).

In 2000, a total of 18% was spent in the area of program development, with computer software taking the biggest chunk at 5% and hardware at 4% for a 9% overall. In 2001, a total of 19% was spent on the same items, however computer software and hardware were combined at 13% overall for a 4% increase in 2001 responses. This increase could be a positive indicator for the industry, as any investment in capital is a sure sign of organizational support. It may also be an indicator that we are becoming more technology-- orientated, as is our sister industry of commercial (non-health care) call centers. (Note: I say may be and could be. Remember the results in the survey are only a reflection of those who entered data. It may also be just the differences in program strategies and category differences in the organization size and population served.)

2. Growth and Development of the Human Resources (orientation and training, ongoing education, recruiting, CQI/QA). The latter is a significant indicator of the ability to manage change. Let's look at how the respondents fared:

In 2000, a total of 9% was spent in the area of human resource development, taking the biggest chunks at 3% each for orientation/training and ongoing education. In 2001, that total dropped to 2% spent on the same items with no funds tagged for recruiting. This is a significant decrease and a possible negative indicator. What we do not know is if the respondents in 2001 just did not know what those expenditures were, but that idea would be hard to support. Remember our human resources are our most valuable assets. After all participants spent 90% of their budget on wages and benefits. Looking at turnover rates (another question in the survey) might be a place to look for an explanation or outcome of this decision. Comparing the losses in costs of wages and benefits to cover turnover may justify an increased budget in training and education. It is a proven fact that education and training promotes retention. In 2001, the participants reported a 50% turnover rate for RNs and a 30% turnover rate for support staff, while in 2000 the vacancy rate was reported as 8% for RNs. This is a sizable variance.