Internet video to support intravenous medication administration in the home: a cost minimisation study

Natalie Bradford, Nigel R Armfield, Jeanine Young, Marissa Ehmer, Rachael Lawson, Anthony C Smith

We compared the costs associated with three different methods of administering antibiotics to paediatric oncology patients. In scenario A, medicine was prepared in the home, checked in the home using a video link to a second nurse, and administered in the home. In scenario B, medicine was prepared by outsourcing the work to a commercial organisation, checked by pharmacists off-site and administered in the home. In scenario C, medicine was prepared in the hospital, checked by a second nurse and administered in the outpatient department. The staff time required for home administration was calculated from actual home visits. The cost of tablet computers and mobile Internet charges for double-checks in the home was based on an assumed useful life of 3 years for the equipment. The cost of outsourcing the preparation of medications was calculated from the actual cost of doing so during a four month period. Patient outcome was assumed to be the same in all three scenarios. The mean costs of a medication episode (i.e. one occasion of medication administration) was $129.91 in scenario A, $312.00 in scenario B and $355.91 in scenario C. Nurse preparation and administration in the home would save the oncology health service $124,899 per annum compared to outsourcing medication preparation. Nurse preparation and administration in the home would save the oncology health service $155,329 per annum compared to nurse preparation and administration in the outpatient department. Use of Internet-based video appears to produce savings compared to other methods of administering antibiotics and the technique may have wider application in supporting complex interventions in the home.