Digital image referral for suspected skin malignancy- A pilot study of 300 patients

Referral interventions from primary to specialist care: a systematic review of international evidence

“…Process changes were defined as smallscale changes to some aspect of the individual referral process that did not involve the movement of staff or relocation of clinics, the methods in which referrals were triaged at hospital, or financial arrangements for referral. Process change interventions included: designated appointment slots and fast-track clinics for primary care referrals (n = 6), [60][61][62][63][64][65] direct access to screening (n = 9), 66 to referral (individual contact between a specialist and GP) (n = 11), [75][76][77][78][79][80][81][82][83][84][85] electronic referral systems (n = 10), [86][87][88][89][90][91][92][93][94][95] decision support tools (n = 10), [96][97][98][99][100][101][102][103][104][105] and waiting list review or watchful waiting (n = 3). [106][107][108] The overall picture for interventions that aim to moderate referral outcomes by changing an element of the referral process is mixed.…”

Diagnostic Value and Cost-Effectiveness of Good Quality Digital Images Accompanying Electronic Referrals for Suspected Skin Malignancies

“…Previous work carried out by different health systems in the field of teledermatology have not shown any significant reduction in cost or effect on the average patient journey. [5][6][7] Waiting times for suspected skin malignancies have reduced since the prospective study by Tadros et al 2 Patients triaged as routine or soon are now having their diagnosis or treatment approximately a week earlier. This may result from better uptake of the ERS by primary care practitioners and the familiarity of the system, as the majority of skin lesions are currently referred through ERS with digital photographs, increasing the number of patients suitable for assessment and treatment at the 1-Stop Clinic.…”

“…Tadros et al 2 followed with a study indicating that electronic referrals improved the waiting times for patients compared with standard referral letters, and the triaging referrals on the basis of accompanying digital images was safe practice, with high intra-and interobserver reliability. The electronic referral system (ERS) and the digital photography pilot project were described by Tadros et al 2 Figure 1 illustrates a summary of the referral pathway. The ERS has since expanded, incorporating the services of the departments of Dermatology and Maxillofacial Surgery, resulting in the Skin Cancer Pathway.…”

Electronic Communication and Digital Images: Referral Pathways and Clinical Uses in Ophthalmology

“…In Brisbane, patient generated photographs of melanocytic skin lesions from camera phones showed 69% diagnostic concordance with face to face diagnosis, suggesting potential for remote diagnosis [2]. In Dundee, referrals of suspected malignant skin lesions from GPs which included digital images had reduced time to diagnosis by 81% and time to treatment by 30%, with diagnostic accuracy comparable to face to face diagnosis [3].…”