ABSTRACT
BACKGROUND: There is an increasing need by general practitioners (GPs) for consultations regarding skin diseases or skin lesions. Teledermatological and teledermoscopic diagnoses are possible with good results. OBJECTIVES: This descriptive study analyzed whether the increasing need for dermatological consultations could be improved by regional teledermatological and teledermoscopic triage between GPs and dermatologists. MATERIALS AND METHODS: Via an internet platform, six GPs sent images of unclear skin diseases or skin lesions to a dermatology practice (2 dermatologists) over a period of 9 months. Possible triage answers were (1) stay at the GP, (2) urgent consultation at the dermatologist (days), or (3) later (week/months) consultation at the dermatologist, respectively, with the diagnosis and therapeutic suggestions. A feedback (grade 1-6) were given by the dermatologists about the image quality and from the GPs about the appraisal. The dermatologists' appraisals were done independently and were audited by a third dermatologist. RESULTS: The patients' acceptance was 100% and a very good to good image quality was achieved in 94%; 66.3% of patients could stay at their GP and 20.7% of patients should come urgently to the dermatologist. The teletriage decisions of an urgent consultation at the dermatologist were confirmed in 41.5%. The GPs' feedback about the teletriage appraisal received an overall average grade of 1.1. CONCLUSION: Successful regional teledermatological and teledermoscopic triage between GPs and dermatologists is possible. Specifications on data privacy laws must be followed and an appropriate remuneration is preferable.
Subject(s)
Dermatologists , General Practitioners , Interprofessional Relations , Skin Diseases , Telemedicine , Triage/methods , Dermatology/trends , Humans , Patient Care Team , Referral and Consultation , Skin Diseases/diagnosis , Skin Diseases/therapyABSTRACT
BACKGROUND: Treatment of chronic ulcers is challenging. Advanced age, comorbidities, and a lack of medical knowledge of the caretaker's relatives are additional burdens. This study analyses if patient driven teledermatology could support them in the treatment of leg ulcers. Another purpose was the evaluation of savings in time and costs through telemedicine. PATIENTS AND METHODS: Over a period of approximately 6 months, 50% of the patients were treated in an ambulant setting, the other 50% used mainly teledermatology. The tele-group used an application to upload their pictures, clinical results, and history. After examination, the expert sent back a treatment plan and a date for the next teleconsultation. RESULTS: In all, 40 patients-20 in the tele-group and 20 in the control group-(18â¯women, 22â¯men; median age: 75â¯years [39-88â¯years]) were included in the study. A total of 4 patients managed the teleconsultation on their own, while 3 patients were supported by relatives and 11 by nurses. Overall, 196 outpatient treatments took place in the control group (1.6 visits/patient/month), compared to 97 outpatient treatments (0.6 visits/patient/month) and 182 teledermatology consults (1.3/patient/month) in the tele-group. Six patients were only treated in the teledermatology setting. CONCLUSIONS: Results from this study suggest that teledermatology is well qualified for the treatment of chronic ulcers; at the same time teledermatology is able to reduce the number of outpatient treatments, in some cases teleconsultation alone is possible. This decreases waiting time and travel costs for patients. Mobile teledermatology for treatment of ulcers was well-accepted among the patients.
Subject(s)
Dermatology , Remote Consultation , Skin Diseases , Skin Ulcer , Telemedicine , Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Skin Ulcer/diagnosis , Skin Ulcer/therapyABSTRACT
BACKGROUND: The use of digital communication media is becoming increasingly important, with the primary aim of improving both treatment quality and patients' quality of life. In an effort to optimize telemedicine in the field of dermatology, we conducted a survey among dermatologists in Austria. METHODS: Statistical analysis of a questionnaire that was developed by a working group and sent to 769 Austrian dermatologists. RESULTS: Overall, 243 dermatologists (132 women/111 men) participated in the survey. Forty-seven percent of male respondents and 55 % of female respondents had already received requests for teledermatology consultations. Seventy-three percent felt that telemedicine was able to contribute to relieving the economic burden on the health care system. Telecommunication between dermatologists and experts (in a given field of dermatology) was deemed to be particularly useful. While telemedicine was also considered to be appropriate for patient follow-up, it was viewed to be less useful for initial consultations. Roughly 50 % of respondents used telemedicine to get a second opinion; one-third used it for initial consultations. CONCLUSIONS: Our survey shows that the majority of participants consider teledermatology to be a useful supplement to the current practice of dermatology. Given its particular usefulness for triage purposes, teledermatology can help reduce the number of trips to the hospital and subsequent waiting times. This in turn leads to cost reduction and saves time for both patients and doctors. Legal regulations that include provisions for appropriate reimbursement of physicians would make using teledermatology more attractive.
