Feasibility and cost of a telemedicine-based short-term plan for initial access in general dermatology in Andalusia, SpainCapsule Summary

• Main Authors: Ruben Barros-Tornay, MD (Author), Lara Ferrándiz, MD, PhD (Author), Francisco J. Martín-Gutiérrez, MD (Author), Almudena Fernández-Orland, MD (Author), Amalia Serrano-Gotarredona, MD (Author), José M. de la Torre, MD (Author), María D. Conejo-Mir, MD (Author), Teresa Ojeda-Vila, MD, PhD (Author), Juan Márquez-Enríquez, MD (Author), Carlos Hernández, MD (Author), María J. Ocaña, MD (Author), Juan M. Herrerías-Esteban, MD (Author), David Moreno-Ramírez, MD, PhD (Author)
• Format: Book
• Published: Elsevier, 2021-09-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2666-3287; 10.1016/j.jdin.2021.05.002
• Keywords: accessibility; dermatology care; health care services; technology; teledermatology; telemedicine; Dermatology; RL1-803
• Source: JAAD International, Vol 4, Iss , Pp 52-57 (2021)

Background: In developed countries, health care delivery in dermatology is hampered by the low availability of dermatologists. Objective: To analyze the feasibility of a teledermatology-based action plan to provide initial dermatologic care in areas with low availability of dermatologists. Methods: A cross-sectional study describing the feasibility and cost of a 12-month action plan based on a store-and-forward teledermatology (TD) connecting primary care centers and a TD center. Teleconsultations from patients complaining of any cutaneous condition were included. The primary outcome measure was the percentage of patients not referred to the local dermatologist. Results: Among the total of 15,523 teleconsultations attended in the TD-based action plan, 3360 (21.65%) required a face-to-face visit with a local dermatologist. In 32.32% (n = 5017) of the cases, a therapeutic and follow-up plan report was issued. The most common conditions managed were melanocytic nevi (15.63%, n = 2426), followed by seborrheic keratosis (14.89%, n = 2312), and actinic keratosis (8.65%, n = 1342). The average response time was 14.52 days (95% CI 14.35-15.23). The additional total investment in this action plan was $142,681.01, with a unit cost of 9.20$/patient. Limitations: Noncontrolled study. Conclusions: Experienced dermatologists working with store-and-forward TD can deliver a fast and effective response in health care areas with access limitations.