Teledermatology in Scotland

C, Crichton; Macdonald, Sue; Potts, S; Syme, A; Toms, Jeremy; McKinlay, Justin; Leslie, David; Dh, Jones

doi:10.1177/1357633x9500100310

Cited by 11 publications

(9 citation statements)

References 1 publication

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“…Clinical teledermatology began in Norway in 1989 21 and was first reported in the UK in 1995 22 . The initial Waikato teledermatology service to Taumarunui compares well with successful American programmes to under‐served populations.…”

Section: Discussionmentioning

confidence: 93%

Retrospective review of teledermatology in the Waikato, 1997–2002

Oakley

Rennie

2004

Aust J Dermatology

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We reviewed scheduled interactive teledermatology consultations from 1997 to 2002 between the Department of Dermatology of Health Waikato in Hamilton and remote sites at Taumarunui Hospital, Taupo Health Centre and the Ranolf Medical Centre, Rotorua, in New Zealand. Eighty-five per cent of 384 appointments were attended and most non-attendances were unexplained. The reason for consulting a dermatologist was inflammatory skin disease in 74% of cases, cutaneous infection in 10%, a skin lesion in 12% and no diagnosis was made in 4%. Follow ups were arranged for 41%, mainly by telemedicine (74%). Despite the apparent success of 75% of consultations and positive feedback from patients attending them, the service has not proved sustainable long-term. This is because of other priorities for the delivery of health care, lack of support by clinicians and administrators, and ongoing financial costs.

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Section: Discussionmentioning

confidence: 93%

Retrospective review of teledermatology in the Waikato, 1997–2002

Oakley

Rennie

2004

Aust J Dermatology

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“…Other authors have claimed that patients are generally more satisfied with teledermatology than are consultant dermatologists, who may find it more difficult to establish a satisfactory doctor-patient relationship 3,15 . This communication problem is one of the reasons why some dermatologists have met telemedicine with fear and loathing 32 .…”

Section: Doctors' Evaluationsmentioning

confidence: 99%

“…Studies have been carried out to evaluate different aspects of teledermatology [1][2][3][4][5][6][7][8][9][10][11] . They have revealed 59-95% diagnostic agreement between face-to-face consultations and videoconferences 2,4,[6][7][8]10,11 .…”

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confidence: 99%

A comparative study of teleconsultations versus face-to-face consultations

Nordal

Moseng

Kvammen³

et al. 2001

J Telemed Telecare

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We compared the diagnoses made by one dermatologist via telemedicine with those of another dermatologist made in a face-to-face consultation. The patients first underwent a teledermatology consultation and then a face-to-face consultation. A general practitioner was present with the patient in the videoconference studio. Videoconferencing equipment connected at 384 kbit/s was used. The doctor-patient relationship and the satisfaction of the patients and dermatologists in the two settings were assessed, as well as technical conditions during the videoconferences. There were 121 patients, with a mean age of 40 years (range 17-82 years). There was a high degree of concordance between the two sets of diagnoses, with 72% complete agreement and 14% partial agreement between the two dermatologists. A total of 116 patients (96% of those included) completed a questionnaire. Both the patients and the dermatologists were in general satisfied with the videoconferences. Videoconferencing with a participating general practitioner may be useful in dermatology, but the technique should be used only for selected patients.

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“…Another study 16 concluded that a third of all referrals to dermatologists could be managed equally well in primary care. Some rigorous evaluations of telemedicine have been reported; 12,[17][18][19][20] however, most published information on telemedicine is anecdotal. 21 The merits of telemedicine must be recognized and explored 22,23 before widespread diffusion.…”

mentioning

confidence: 99%

Comparison of teleconsultations and face-to-face consultations: preliminary results of a United Kingdom multicentre teledermatology study

et al. 1998

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The objective of this multicentre study was to undertake a systematic comparison of face-to-face consultations and teleconsultations performed using low-cost videoconferencing equipment. One hundred and twenty-six patients were enrolled by their general practitioners across three sites. Each patient underwent a teleconsultation with a distant dermatologist followed by a traditional face-to-face consultation with a dermatologist. The main outcome measures were diagnostic concordance rates, management plans and patient and doctor satisfaction. One hundred and fifty-five diagnoses were identified by the face-to-face consultations from the sample of 126 patients. Identical diagnoses were recorded from both types of consultation in 59% of cases. Teledermatology consultations missed a secondary diagnosis in 6% of cases and were unable to make a useful diagnosis in 11% of cases. Wrong diagnoses were made by the teledermatologist in 4% of cases. Dermatologists were able to make a definitive diagnosis by face-to-face consultations in significantly more cases than by teleconsultations (P = 0.001). Where both types of consultation resulted in a single diagnosis there was a high level of agreement (kappa = 0.96, lower 95% confidence limit 0.91-1.00). Overall follow-up rates from both types of consultation were almost identical. Fifty per cent of patients seen could have been managed using a single videoconferenced teleconsultation without any requirement for further specialist intervention. Patients reported high levels of satisfaction with the teleconsultations. General practitioners reported that 75% of the teleconsultations were of educational benefit. This study illustrates the potential of telemedicine to diagnose and manage dermatology cases referred from primary care. Once the problem of image quality has been addressed, further studies will be required to investigate the cost-effectiveness of a teledermatology service and the potential consequences for the provision of dermatological services in the U.K.

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Teledermatology in Scotland

Cited by 11 publications

References 1 publication

Retrospective review of teledermatology in the Waikato, 1997–2002

Retrospective review of teledermatology in the Waikato, 1997–2002

A comparative study of teleconsultations versus face-to-face consultations

Comparison of teleconsultations and face-to-face consultations: preliminary results of a United Kingdom multicentre teledermatology study

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