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August 9, 1995


Author Affiliations

University of Kansas Medical Center Kansas City
Oregon Health Sciences University Portland

JAMA. 1995;274(6):462. doi:10.1001/jama.1995.03530060035028

In Reply.  —The MCG is unusual in its emphasis on medical consultation to support its ambitious project. Most telemedicine projects use their expensive teleconferencing infrastructure for nonclinical purposes because consultations alone cannot justify the capital and operating costs. Simple arithmetic applied to the MCG project illustrates this point. In 1994, their third year of operation, the MCG had six sites operating at an equipment cost of about $135 000 per site, or $810 000 total.1,2 About 132 patient-physician consults were done, with an approximate average time per consult of 33 minutes.3 Therefore, total system time for clinical consultation was about 73 hours (132×0.55 hours). Thus, the average weekly utilization rate was about 1.8 hours overall, or less than 20 minutes per site. Assuming 5-year straight-line depreciation, equipment costs amount to $162 000 per year, or about $2219 per hour of consultation. This figure does not include the cost

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