Teledermatology applied following patient selection by general practitioners in daily practice improves efficiency and quality of care at lower cost
Abstract
Summary: Background Teledermatology, the application of telemedicine in the field of dermatology, has similar accuracy and reliability as physical dermatology. Teledermatology has been widely used in daily practice in the Netherlands since 2005 and is fully reimbursed. Objectives This study prospectively investigated the effect of teledermatology on efficiency, quality and costs of care when integrated in daily practice and applied following patient selection by the general practitioner (GP). Methods Teledermatology consultations between GP and regional dermatologist were performed in daily GP practice in the Netherlands. Efficiency of care was measured by the decrease in the number of physical referrals to the dermatologist. Quality of care was measured by the percentage of teleconsultations for second opinion, physical referrals resulting from these teleconsultations, the response time of the dermatologists and educational effect experienced by the GP. Costs of conventional healthcare without teledermatology were compared with costs with teledermatology. Results One thousand, eight hundred and twenty GPs and 166 dermatologists performed teledermatology, and 37 207 teleconsultations performed from March 2007 to September 2010 were included. In the group of patients where the GP used teleconsultation to prevent a referral (n =26 596), 74% of physical referrals were prevented. In the group of patients where the GP used teleconsultation for a second opinion (n =10 611), 16% were physically referred after teleconsultation. The prevented referral rate in the total population was 68%. The mean response time of dermatologists was 4·6 h (median 2·0). GPs indicated that there was a beneficial educational effect in 85% of the teleconsultations. The estimated cost reduction was 18%. Conclusions Teledermatology can lead to efficient care probably at lower cost. We are therefore of the opinion that teledermatology following GP selection should be considered as a possible pathway of referral to secondary care.
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Many countries have tested the use of telemedicine in dermatology as a way to increase access to health care services when distance is a critical factor.
“Many countries have tested the use of telemedicine in dermatology as a way to increase access to health care services when distance is a critical factor [18-26].”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [25]
Tele-dermatology decreases the number of face-to-face referrals by up to 74%.
“dermatologists also noted that tele-dermatology decreased the number of face-to-face referrals by up to 74% (van der Heijden et al., 2011).”
From Patient and practitioner satisfaction with tele-dermatology including Australia’s indigenous population: A systematic review of the literature (2016) · cites this paper as van der Heijden et al., 2011
Tele-dermatology offers an educational benefit to GPs, with 85% of GPs reporting increased knowledge of dermatology following tele-consults.
“Tele-dermatology offers an educational benefit to GPs, as evidenced by van der Heijden et al. (2011) who found that 85% of GPs reported increased knowledge of dermatology following tele-consults.”
From Patient and practitioner satisfaction with tele-dermatology including Australia’s indigenous population: A systematic review of the literature (2016) · cites this paper as van der Heijden et al., 2011
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- Authors
- van der Heijden, J. P., de Keizer, N. F., Bos, J. D., Spuls, P. I., & Witkamp, L.
- Affiliations
- Departments of Dermatology
- Medical Informatics, Academic Medical Centre, University of Amsterdam, PO Box 22700, 1100 DE Amsterdam, the Netherlands
- KSYOS TeleMedical Centre (NL)
- Venue
- British Journal of Dermatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-11-01
- Volume
- 165
- Issue
- 5
- Pages
- 1058-1065
- ISSN
- 0007-0963 (ISSN-L)
- 1365-2133
- OpenAlex
- W1540783215
- Cited by
- 160
- References
- 30
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 7 · 2023: 9 · 2022: 7 · 2021: 8 · 2020: 17 · 2019: 8 · 2018: 15 · 2017: 12 · 2016: 18 · 2015: 16 · 2014: 15 · 2013: 10 · 2012: 5
- FWCI
- 10.36
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- British Journal of Dermatology (publishedVersion)
- PubMed (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Keywords
- teledermatology, telemedicine, dermatology, general practitioners, second opinion, health care costs, quality of care, efficiency of care, GP education
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Child, Child, Preschool, Costs and Cost Analysis, Dermatology, Family Practice, Female, Humans, Infant, Infant, Newborn, Male, Middle Aged, Netherlands, Professional Practice, Prospective Studies, Quality of Health Care, Retrospective Studies, Skin Diseases, Urban Health, Efficiency, Organizational, Patient Selection, Remote Consultation, Young Adult
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