COST ISSUES SURROUNDING THE USE OF COMPUTERIZED TELEMEDICINE FOR OBSTETRIC ULTRASONOGRAPHY

Objective The purpose of this study was to describe the cost implicati ons of converting an established videotape review network for obstetri c ultrasonography to one based on telemedicine technology. Design Retr ospective review of fixed and non-fixed costs associated with interpre ting obstetric ultrasound examinations using both videotape and teleme dicine transmission. Subjects A network of three community offices tra nsmitting 600 obstetric ultrasound examinations per month to a central tertiary level facility. Methods Sonographers at the community office s record ultrasound examinations onto videotape, which are then sent b y courier to a central facility for interpretation. As the completion of this videotaped examination, sonographers repent the ultrasound sca n while transmitting real-time images over a telemedicine link to the central facility. Costs associated with the videotape review technique that can be avoided by converting to telemedicine interpretation were derived and compared with the fixed and non-fixed costs associated wi th establishing the telemedicine network. Results For this network, th e fixed costs for establishing telemedicine are $101 750. Monthly non- fixed cost savings by eliminating videotape review include $1620 to $2 700 for printing still images, $1200 for courier charges and $7000 for fewer repeat ultrasound examinations. Monthly non-fixed costs for the telemedicine network are $2415. Net monthly savings in non-fixed cost s for a telemedicine network me therefore $7405 to $8585, which may pa y for the initial fixed costs in 12 to 14 months. Conclusions The high cost of a telemedicine network may be offset by possible savings in n on-fixed costs compared with alternative systems for interpreting obst etric ultrasonography.