Telemedicine services for two islands in the Bay of Naples

Abstract

In July 1997, telemedicine services were established for two islands, Procida and Ischia, in the Bay of Naples. The telemedicine network allowed a 24 h consultation service to be provided between the islands' health centres and mainland hospitals in the towns of Pozzuoli and Giugliano. Realtime videoconferencing was used, over an ISDN link at 384 kbit/s; radiographs were digitized using a scanner. During 1999 and 2000, there was an average of 46 telemedicine consultations per year from Procida (60% radiology, 30% cardiology, 10% other), 35% of which were emergencies, and 16 training sessions per year; there was an average of 28 telemedicine consultations per year from Ischia (80% radiology, 10% cardiology, 10% other), 10% of which were emergencies, and 12 training sessions per year. The average duration of a telemedicine consultation was 15 min. The total fixed cost of the telemedicine system between the two islands and the two mainland hospitals was approximately Euro 48,000 per year. The total variable costs of the telemedicine service at the observed workload were about Euro 750 per year. The total savings due to telemedicine were approximately Euro 40,000 per year. There was therefore little difference in the overall costs of health-care delivery. The positive consequences of the introduction of the telemedicine service included more rapid diagnosis and treatment, improved quality of service, and the transfer of skills and education. A costs-consequences analysis suggested that the telemedicine service was worthwhile.

Systematic review of studies of the cost-effectiveness of telemedicine and telecare. Changes in the economic evidence over twenty years

“…Most studies described the telemedicine intervention explicitly, but costs and outcomes in relation to the comparator were not reported in sufficient detail to make proper comparisons. For example, Bracale and colleagues 12 compared telemedicine with the alternative of patient transfer by boat or by helicopter ambulance. They described how the telemedicine services were established and how they worked, but no further details were given about the comparator. Type of economic evaluation adopted for the telemedicine study.…”

The socio-economic impact of telehealth: A systematic review

“…There is good evidence that interactive videoconsultation is effective and efficient in rural and remote areas (Table 9), and increases access to healthcare [66][67][68] . Studies have been conducted in the following clinical areas: radiology, cardiology 69 , colposcopy 70 , neuropsychology 71 , minor injuries 72 , dermatology 73 and nutrition 74,75 . Other socio-economic implications include the avoidance of travel for patients and providers, improved access to services, increased quality of care and cost-savings.…”

Development and evaluation of a teleradiology and videoconferencing system

“…However, the system is still being developed and some desirable features are still not available. The introduction of a teleradiology system between the SGH on Sado Island and hospitals in Niigata City was beneficial for both the diagnostic radiologist at the SGH and patients on the island, as has been found in other studies of telemedicine systems for islands [8][9][10] . The teleradiology system enables a prompt consultation with specialists in Niigata City.…”