mHealth Research Digest with Tim Bredrup

Telemedicine applications in the field of dermatology, also known as teledermatology, have been widely used in the Netherlands since 2005 with similar accuracy and reliability as physical dermatology.

In order to contribute to the evidence base in this area of research, dermatology medical informaticists at the University of Amsterdam performed a study to determine the effect of teledermatology on the efficiency, quality and costs of care when integrated into daily practice, following patient selection by a general practitioner (GP).

Daily teledermatology consultations were performed between GPs and regional dermatologists in the Netherlands. The number of physical referrals from the GP to the dermatologist was used to measure efficiency.

To measure the quality of care, the study referred to the percentage of second opinion teleconsultations, the physical referrals resulting from them, the dermatologists’ response times, and the educational effect experienced by the GP.

Costs associated with teledermatology were then compared to the costs of conventional healthcare without the use of teledermatology.

“1,820 GPs and 166 dermatologists performed teledermatology, and 37,207 teleconsultations performed from March 2007 to September 2010 were included,” the informaticists reported. “In the group of patients where the GP used teleconsultation to prevent a referral, 74% of physical referrals were prevented. In the group of patients where the GP used teleconsultation for a second opinion, 16% were physically referred after teleconsultation.”

The prevented referral rate was 68% of the total study population, and the mean response time of dermatologists was 4.6 hours with a median of 2.0 hours. According to the data, the estimated cost reduction was 18% while the GPs indicated that 85% of the teleconsultations provided a beneficial educational effect.

After reviewing the results, it was concluded that teledermatology can very well lead to efficient care and will most likely do so at lower costs.

Because of this conclusion, those involved in the study inferred, “We are therefore of the opinion that teledermatology following GP selection should be considered as a possible pathway of referral to secondary care.” These findings could inform the use of telemedicine by rural family medicine physicians in the US.

Authors: van der Heijden JP, de Keizer NF, Bos JD, Spuls PI, Witkamp L.

Institution: Departments of Dermatology Medical Informatics, Academic Medical Center, University of Amsterdam, The Netherlands.

Original Abstract: PubMed