Cost issues surrounding the use of computerized telemedicine for obstetric ultrasonography

Objective The purpose of this study was to describe the cost implications of converting an established videotape review network for obstetric ultrasonography to one based on telemedicine technology. Design Retrospective review of fixed and non‐fixed costs associated with interpreting obstetric ultrasound examinations using both videotape and telemedicine transmission. Subjects A network of three community offices transmitting 600 obstetric ultrasound examinations per month to a central tertiary level facility. Methods Sonographers at the community offices record ultrasound examinations onto videotape, which are then sent by courier to a central facility for interpretation. At the completion of this videotaped examination, sonographers repeat the ultrasound scan 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 with establishing the telemedicine network. Results For this network, the fixed costs for establishing telemedicine are $101 750. Monthly non‐fixed cost savings by eliminating videotape review include $1620 to $2700 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 costs for a telemedicine network are therefore $7405 to $8585, which may pay 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 non‐fixed costs compared with alternative systems for interpreting obstetric ultrasonography. Copyright © 1998 International Society of Ultrasound in Obstetrics and Gynecology