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International Journal of Telemedicine and Applications
Volume 2012 (2012), Article ID 729492, 10 pages
Research Article

A Modeled Analysis of Telehealth Methods for Treating Pressure Ulcers after Spinal Cord Injury

1Truven Health Analytics, Washington, DC 20008, USA
2Center for Primary Care and Outcomes Research, Stanford University, Stanford, CA 94305-6019, USA
3Spinal Cord Injury Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA 94304, USA
4Center for Health Care Evaluation, Veterans Affairs Palo Alto Health Care System, 795 Willow Road (152 MPD), Menlo Park, CA 94025, USA
5Department of Sociology, Stanford University, Stanford, CA 94305-2047, USA

Received 2 May 2012; Accepted 12 July 2012

Academic Editor: George Demiris

Copyright © 2012 Mark W. Smith et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Home telehealth can improve clinical outcomes for conditions that are common among patients with spinal cord injury (SCI). However, little is known about the costs and potential savings associated with its use. We developed clinical scenarios that describe common situations in treatment or prevention of pressure ulcers. We calculated the cost implications of using telehealth for each scenario and under a range of reasonable assumptions. Data were gathered primarily from US Department of Veterans Affairs (VA) administrative records. For each scenario and treatment method, we multiplied probabilities, frequencies, and costs to determine the expected cost over the entire treatment period. We generated low-, medium-, and high-cost estimates based on reasonable ranges of costs and probabilities. Telehealth care was less expensive than standard care when low-cost technology was used but often more expensive when high-cost, interactive devices were installed in the patient’s home. Increased utilization of telehealth technology (particularly among rural veterans with SCI) could reduce the incidence of stage III and stage IV ulcers, thereby improving veterans' health and quality of care without increasing costs. Future prospective studies of our present scenarios using patients with various healthcare challenges are recommended.