%0 Journal Article
%T A Modeled Analysis of Telehealth Methods for Treating Pressure Ulcers after Spinal Cord Injury
%A Mark W. Smith
%A Michelle L. Hill
%A Karen L. Hopkins
%A B. Jenny Kiratli
%A Ruth C. Cronkite
%J International Journal of Telemedicine and Applications
%D 2012
%I Hindawi Publishing Corporation
%R 10.1155/2012/729492
%X 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. 1. Introduction Telehealth, or telemedicine, is the use of telecommunications and information technology to provide health care when distance separates the participants. A number of studies have shown that home telehealth interventions can improve clinical outcomes for a variety of conditions such as dermatology [1] and diabetes [2¨C4]. Several studies have investigated its use in persons with spinal cord injury (SCI), in particular for the ability to detect and stage pressure ulcers (PUs) [5, 6]. Multiple intrinsic and extrinsic factors make these ulcers common in patients with SCI. For example, transfer-mobility problems, home-environment adaptive equipment issues, recreational activities, spasticity, and bowel and bladder incontinence may all contribute to the occurrence of skin compromise and PU development. Telehealth appears to be a logical option for PU diagnosis and followup, particularly when the patient is not close to a local facility or transportation is difficult. However, there has been no investigation into the costs and potential savings associated with its use for persons with SCI in the US Department of Veterans Affairs (VA) health care system. This is unfortunate because of the relatively large number of patients with
%U http://www.hindawi.com/journals/ijta/2012/729492/