A feasibility study of realtime teledermatology in Finland

Abstract

We conducted a feasibility study of teleconsultation in dermatology using low-cost equipment. Patients and their general practitioners took part in consultations from the Primary Health Care Centre in Ikaalinen with a dermatologist 55 km away at the Tampere University Hospital (TAUH). Consultations were performed using standard commercial videoconferencing equipment, a modified document camera and a dermatoscope. A single ISDN line (128 kbit/s) was used for the connection. During the eight months of the study, 25 patients participated in a teledermatology consultation. Their mean age was 45 years (range 4-92). The average time the patient spent in travelling to the videoconsultation (i.e. one way) was 24 min (range 5-65 min). The mean time spent in the teleconsultation was 15 min (range 5-30 min). After the teleconsultation, patients' treatments changed in 19 cases (76%), diagnoses were changed in 13 cases (52%) and 18 patients (72%) did not need to go to the TAUH. The equipment was generally reliable and easy to use. However, the dermatoscope was not very useful and only one of the consultations relied mainly on it. The cost of the teleconsultations for the 18 patients who avoided travel to the TAUH was FM18,627. The total costs for the 18 conventional consultations in the TAUH would have been FM18,034. The main economic benefits of the videoconferencing were attributable to the reduced travelling and hospital costs. The economic benefits of medical education were more difficult to quantify.

Wound Teleconsultation in Patients with Chronic Leg Ulcers

“…Several studies showing the feasibility and usefulness of e-visits in dermatology have already been described in the literature, and a high accordance for diagnosis between live visits and e-consultations has been reported in all of them [2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16]. Most of these studies demonstrate high accordance for the diagnosis of inflammatory and neoplastic skin diseases [17, 18, 19, 20, 21], and particularly for the diagnosis of pigmented skin lesions (teledermoscopy) [22, 23, 24, 25, 26].…”

Teledermatology for diagnosis and management of skin conditions: A systematic review

“…Of the 3 studies without a comparison group, the reported satisfaction ratings were 44%, 46 88%, 64 and 92%. 65 Overall. Of the 5 studies that included both teledermatology (either SAF or LI) and clinic dermatology groups, patients expressed comparable levels of satisfaction in 3 of the studies (all of which were randomized controlled trials).…”

Mobile teledermatology coming of age

“…Because of its visual nature our skin is easily accessible for digital imaging (Eedy, Wootton 2001). Currently, there exist two main types of teledermatology: live interactive video (''real time'') or the ''store and forward''-technology (Loane, 2000;Lamminen, 2000). In the first case the participants are separated by distance, but interactive in time.…”