Teledermatology reduces the number of patient referrals to a dermatologist

Abstract

During a two-year study, 505 teledermatology consultations were carried out on 503 patients of 29 participating general practitioners (GPs) in the province of Friesland. One overview and two detail digital photographs of the skin problems were taken on a digital camera and attached to an email message containing standard clinical information. These email messages were sent to a dermatologist, who replied by email after evaluation. After a median follow-up time of 548 days, the GPs were interviewed about the dermatological referrals. The reduction in referrals was 51% (0.95 confidence interval = 47-58%) when the GP had the intention to refer. When the GPs had no intention to refer, there turned out to be a secondary traditional consultation in 17% of cases. The reduction of 51% of referrals after store-and-forward teledermatology consultation was similar to that seen in other studies of videoconferencing. Consultation using digital store-and-forward teledermatology by the GP can halve the number of referrals to a dermatologist for selected patients.

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

“…The percentage of visits avoided ranged from 12.8% to 72%. 10,15,17,32,63,65,68,71 The study that reported 12.8% clinic dermatology visits avoided also reported that 33.1% required clinic dermatology surgery. 15 Conclusions.…”

Referral interventions from primary to specialist care: a systematic review of international evidence

“…Process changes were defined as smallscale changes to some aspect of the individual referral process that did not involve the movement of staff or relocation of clinics, the methods in which referrals were triaged at hospital, or financial arrangements for referral. Process change interventions included: designated appointment slots and fast-track clinics for primary care referrals (n = 6), [60][61][62][63][64][65] direct access to screening (n = 9), 66 to referral (individual contact between a specialist and GP) (n = 11), [75][76][77][78][79][80][81][82][83][84][85] electronic referral systems (n = 10), [86][87][88][89][90][91][92][93][94][95] decision support tools (n = 10), [96][97][98][99][100][101][102][103][104][105] and waiting list review or watchful waiting (n = 3). [106][107][108] The overall picture for interventions that aim to moderate referral outcomes by changing an element of the referral process is mixed.…”

Teledermatological Monitoring of Leg Ulcers in Cooperation With Home Care Nurses

“…In our study, we found a marked reduction in these outpatient visits. Therefore, a distinct reduction in transport costs for the patients was achieved, an advantage of teledermatology 12 over the usual treatment modalities.…”