Table 6: System-level cost implications of standard care versus telehealth.

Cost estimatesa
LowMediumHigh

Scenario 1: Preventive care, new injuries
 Within SCI homecare catchment area
  Net savings: Usual-telehealth option 1b$214,560 to $262,240$334,656 to $409,024$614,016 to $750,464
 Outside SCI homecare catchment area
  Net savings: Usual-telehealth option 1b
$-1,864,944 to $-2,279,376$-1,743,408 to $-2,130,832$-664,128 to $-811,712
  Net savings: Usual-telehealth option 2c
$89,136 to $108,944$169,344 to $206,976$1,313,712 to
$1,605,648

Scenario 2: Existing pressure ulcer
 Outside SCI homecare catchment area
  Net savings: Usual-telehealth option 3
$1,550,160 to $1,894,640$1,704,960 to $2,083,840$1,870,560 to $2,286,240

Scenario 3: Postsurgical care
 Within SCI homecare catchment area
  Net savings: Standard-telehealth option 1b
$-160,402 to $-196,046$-135,302 to $-165,370$-13,997 to $-17,107
  Net savings: Standard-telehealth option 3d
$87,480 to $106,920$111,456 to $136,224$183,773 to $224,611
 Outside SCI homecare catchment area
  Net savings: Standard-telehealth option 1b
$-176,040 to $-215,160$-148,694 to
$-181,738
$-25,574 to
$-31,258
  Net savings: Standard-telehealth option 3d
$28,901 to $35,323$47,520 to $58,080$114,005 to $139,339

Total net savings implications based on
 Telehealth 1 for scenario 1 within SCI CA
 Telehealth 1 for scenario 1 outside SCI CA
 Telehealth 3 for scenario 2 outside SCI CA
 Telehealth 1 for scenario 3 within SCI CA
 Telehealth 1 for scenario 3 outside SCI CA
$-436,666 to $-533,702$12,211 to $14,925$1,780,877 to $2,176,627

Total net savings implications based on
 Telehealth 1 for scenario 1 within SCI CA
 Telehealth 2 for scenario 1 outside SCI CA
 Telehealth 3 for scenario 2 outside SCI CA
 Telehealth 3 for scenario 3 within SCI CA
 Telehealth 3 for scenario 3 outside SCI CA
$1,970,237 to $2,408,067$2,367,936 to $2,894,144$4,096,066 to $5,006,302

CA: Catchment area; SCI: spinal cord injury; VA: U.S. Department of Veterans Affairs.
aFigures are in 2007 dollars.
bTelehealth option 1 used an interactive videoconferencing machine that was installed in the patient’s home. cTelehealth option 2 used the same machine plus station-to-station (hub and spoke) teleconferencing. dTelehealth option 3 used low-cost equipment such as digital cameras and e-mail.