Teledermatology As Best Practice After Patient Selection By General Practitioner

Background: Teledermatology in The Netherlands has been used in daily practice since 2005 and is fully reimbursed. Today, in The Netherlands, over 50% of general practitioners (GPs) and 75 % of the dermatologists use teledermatology. Aim: Study the effect of teledermatology on 1) referrals between GPs and dermatologists and 2) quality of care in day-to-day practice. Methods: Data from day-to-day practice was used. The GPs selected patients for teledermatology. Patients with pigmented lesions were excluded. GPs sent teledermatology consults (TDCs) to dermatologists, to whom they would normally refer. Outcome measures regarding TDCs performed through KSYOS TeleMedical Centre were evaluated: prevented or additional physical referrals through teledermatology (TD), response time, and General Physician's experienced on usefulness and learning effect. Results: From 2006 - 2009 data of 21.212 TDCs were collected. They concerned 44.3% male and 55.7% female (mean 43,6 years). GPs (1.451) and dermatologists (113) were merely situated in urban areas. In the group of patients, whom the GPs would have physically referred in case teledermatology were not available (n=10.478), a 73.8% reduction of physical referrals was accomplished. In the group the GP would not have physically referred if teledermatology were not available (n=4.046), 17.2% were physically referred. Mean response time of dermatologists was 5.6 hours (median 3.0). In 87.0% of the cases, the concerned GP indicated that TD was (very) helpful and for 86.0% of the cases that he had learned (a lot). Conclusions: The use of TD contributes to improvement of quality of care for the patient group selected by the GP for TD. In this group TD should be regarded as best practice. []