Teleconsultation: changes in technology and costs over a 12-year period

Abstract

In our previous study, in 1997, we evaluated the cost of teleconsultations in a primary care centre compared with the cost of the conventional alternative, travelling to the hospital. The results showed that teleconsultations were cheaper than patient travel when the annual workload was more than 110 patients in ophthalmology and 115 patients in dermatology. Using the same method of analysis for 2009 data showed that cost savings would occur if the annual workload was 20 patients in ophthalmology and 17 patients in dermatology. The main differences between the two studies are the reduced cost of the technology (which was based on PCs in 2009) and the increased cost of staff. Both studies show that teleconsultations can be cost-effective in a relatively small health centre. The cost of technology continues to decrease, although the other costs in our break-even analysis continue to increase. However, the usability of technology continues to improve, and this will make telemedicine a more attractive alternative in the future.

Image quality and diagnostic accuracy of a handheld nonmydriatic fundus camera: Feasibility of a telemedical approach in screening retinal diseases

“… 19 Examinations through teleophthalmology were shown to be less expensive than conventional in-person examinations. 20 A study showed that screening for DR in a community health center was 35% less costly when telemedicine was used rather than direct observation. 21 Use of telemedicine screening for DR among populations in underdeveloped rural areas showed cost efficiency, but the expense of maintaining remote imaging facilities in such circumstances may render annual testing economically impractical.…”

Telemedicine: Pediatric Applications

“…Equally important considerations are software, information technology support, administration costs, training, licensing fees, software updates, and the time available to provide the services of both originating and distant site providers. 9,125 Less easily quantified costs must also be considered. For example, one Australian group found more time was needed for a telemedicine visit than for an in-person visit, although other providers with more extensive experience have not found this to be the case.…”

Dismantling Sociocultural Barriers to Eye Care with Tele-Ophthalmology: Lessons from an Alberta Cree Community

“…Our interviews with patients con rmed that our program was successful at overcoming both of these barriers. Although there are start-up costs for purchasing equipment, tele-ophthalmology has been shown to save costs to the healthcare system and patients in the longterm, and is therefore a more nancially sustainable alternative than hospital-based screening for many remote lower-resource settings [14][15][16].…”