Teledermatology Service in Tayside Dr CJ Fleming

Definition Teledermatology is the practice of medicine at a distance which allows access to specialist dermatological knowledge by means of telecommunication and information technology.

Methods 1)Audit on Teledermatology Service 2)GP survey 3)Data on referrals to our dermatology department 4)Cost/benefit analysis

Audit - 4 week period (9 Nov 2010 to 3 Dec 2010) was undertaken to assessed the impact of the digital images on the management process. - Total referrals to dermatology- 619

Quality of photographs - There were between 1 to 8 digital photographic attachments per referral. - On average 2 attachments per referral.

Did the image help?

Outcome

Telediagnosis vs Final Diagnosis

Diagnosis from photoConfirmed Diagnosis Odd moleCompound naevus Atypical NaevusBenign Naevus SCCLentigo maligna BCCSCC BCPAK AK/ BCCBowen’s Viral wartMolluscum ?Bowen’sBCP ?SCC/ BCCGranulomatous rosacea ?SCCBCC Inflamed naevus PPDVenous eczema

GP Survey -A survey monkey was conducted in July 2011 to assess the opinion of primary care users of the system. -94 responses out of 68 practices -80.8% found the service extremely helpful or helpful. -50% found teledermatology time consuming. The main obstacles was locating cameras and time to attach images.

Estimated time for each teledermatology referral

Feedback -65 comments -20 specifically mention that feedback given was greatly valued as it adds to the educational experience.

Costs Analysis PER ANNUM - Once off camera costs: 68x£200=£ If cameras last 5 years, annual cost= £2720 -Digital Storage £600 -Consultant time £570 -IT staff salary £624 -Total Cost : £1794 -(fr secondary care perspective)

Savings PER ANNUM Based on our audit, there is a saving of £ Saving from patient transport= £3 600 Total savings £ Cost Savings = £30 018

Summary -Model based on primary care practitioners acquiring images has proved successful -Simple system, which is integrated in Tayside general referral system -High uptake -Patient Journey