A three-year review of telemedicine at the community level - clinical and fiscal results

The Telemedical Emergency Neurosurgical Network (TENN) was developed to establish community-level access to neurosurgical critical care services for an underserved urban population. Since October 1994, the system has provided round-the-clock connectivity between a single peripheral hospital and a 10-station receiving network which includes physicians' homes and offices. Data from the first 35 months of operation confirm clinical efficacy and cost-effectiveness. The primary benefit was in providing rapid access to care for an 'at-risk' underserved population in emergencies. This undoubtedly resulted in the actual saving of life and prevention of permanent disability. The total costs over the 35 months were calculated as $64,375 and the total savings (mainly in avoided air transport) were $626,149, a net saving of $561,774.