1. Teledermatology Service in Tayside Dr CJ Fleming

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

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

4. 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

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

6. Did the image help?

7. Outcome

8. Telediagnosis vs Final Diagnosis

9. 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

10. 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.

11. Estimated time for each teledermatology referral

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

13. Costs Analysis PER ANNUM - Once off camera costs: 68x£200=£13600 -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)

14. Savings PER ANNUM Based on our audit, there is a saving of £28 212 Saving from patient transport= £3 600 Total savings £31 812 Cost Savings = £30 018

15. 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