• Karen C McKoy, Sharon DiGregorio, and Lisa Stira.
• Department of Dermatology, Lahey Clinic Medical Center, Dover, Massachusetts 02030, USA. thrlmcky@massmed.org
• Telemed J E Health. 2004 Jan 1; 10 Suppl 2: S-70-80.

AbstractThis study evaluated the accuracy, access time, cost, and acceptance by patients and physicians of asynchronous teledermatology referrals in an urban primary care practice. Primary care physicians in a multi-specialty group referred patients for a teledermatology consult. Same-day history and digital images taken by a nurse were electronically sent to a dermatologist who rendered a diagnosis to the physician. Fifty-two patients completed the study. History was adequate for diagnosis in 81% of cases; images were adequate in 75% of cases. Accuracy of the teledermatology diagnosis in cases with adequate images was 97%; accuracy for all cases was 92%. A dermatology visit was recommended in 26% of cases with adequate images, and 42% of all cases. Access time for a teledermatology opinion was 1.9 days versus 52 days for a regular dermatology appointment. Patient and referring physician were highly in favor of teledermatology. Cost evaluations for 20% of patients suggested the cost of a remote consult to be significantly less than the cost of performing an in-person referral. Asynchronous teledermatology may serve as a valuable tool for triage of dermatology referrals and possibly for delivering care to more patients than in urban areas. It can decrease waiting time for a dermatology diagnosis. In an urban multi-specialty clinic-based primary care practice, results suggest the cost of a teledermatology consult is less than that of an in-person service.

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