Remote ophthalmology services: cost comparison of telemedicine and alternative service delivery options

We calculated the cost of an established tele-ophthalmology service, from a health-provider's perspective, and compared this with the cost of three other existing eye-care service delivery options. During a 12-month study period, 118 persons took part in the tele-ophthalmology consultations between a rural clinic located approximately 900 km from the Lions Eye Institute in Perth. The variable costs of tele-ophthalmology were $166.89 (Australian dollars) per patient, and the alternatives cost $445.96, $271.48 and $665.44 per patient. Tele-ophthalmology incurred a set-up cost of $13,340. The threshold at which tele-ophthalmology became cheaper than any of the alternative options occurred at a workload of 128 patients. Tele-ophthalmology offers a viable alternative to conventional eye-care service in rural and remote areas.