Cost implications of outpatient teleneurology

A randomized controlled trial was conducted to compare the costs of realtim e teleneurology with the cost of conventional neurological care. Two distri ct hospitals in Northern Ireland were equipped with videoconferencing units and were connected to the regional neurological centre by ISDN at 384 kbit /s. Of 168 patients randomized to the study, 141 kept their appointments (7 6 male, 65 female). Sixty-five patients were randomized to a conventional c onsultation while 76 were randomized to a teleconsultation. The average age was 44 years of those seen conventionally and 42 years of those seen by te lemedicine. The groups had similar diagnoses. The telemedicine group requir ed more investigations and reviews than the conventional group. The average cost of the conventional consultation was pound 49 compared with pound 72 for the teleconsultation. Realtime teleneurology was not as cost-effective as conventional care.