Teledermatology's impact on time to intervention among referrals to a dermatology consult service

Telemed J E Health. 2002 Fall;8(3):313-21. doi: 10.1089/15305620260353207.

Abstract

The aim of this study was to determine if a teledermatology consult system, using store-and-forward digital imaging technology, results in patients achieving a shorter time from referral date to date of initial definitive intervention when compared to a traditional referral process. Patients being referred to the dermatology consult service from the primary care clinics at the Durham VA Medical Center were randomized to either a teledermatology consultation or usual care. A usual care consultation consisted of a text-based electronic consult request. A teledermatology consultation included digital images and a standardized history, in addition to the text-based electronic consult. Time to initial definitive intervention was defined as the time between referral date and the date the patient was scheduled for a clinic visit for those patients that the consultant requested a clinic-based evaluation, or the time between referral date and the date the consult was answered by the consultant if a clinic visit was not required. Patients in the teledermatology arm of the study reached a time to initial definitive intervention significantly sooner than did those patients randomized to usual care (median 41 days versus 127 days, p = 0.0001, log-rank test). Additionally, 18.5% of patients in the teledermatology arm avoided the need for a dermatology clinic-based visit compared to zero patients avoiding a dermatology clinic visit in the usual care arm of the study (p < 0.001, z-test). Teledermatology consult systems can result in significantly shorter times to initial definitive intervention for patients compared to traditional consult modalities, and, in some cases, the need for a clinic-based visit can be avoided.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Chi-Square Distribution
  • Dermatology / methods
  • Dermatology / statistics & numerical data*
  • Female
  • Hospitals, Veterans / organization & administration
  • Humans
  • Male
  • Medical Records Systems, Computerized*
  • Middle Aged
  • North Carolina
  • Outpatient Clinics, Hospital
  • Primary Health Care
  • Referral and Consultation / organization & administration*
  • Referral and Consultation / statistics & numerical data
  • Remote Consultation / organization & administration*
  • Remote Consultation / statistics & numerical data
  • Time Factors
  • Time and Motion Studies