Transcript No Slide Title - Centre for Health Economics and Medicines

EARLY EVALUATION OF TELEDERMATOLOGY
Pat Linck, Rhiannon Tudor Edwards,
IN RURAL NORTH WALES
Bruce Napier and Catherine Robinson
Project objective
To conduct a service evaluation of existing
teledermatology services and new teledermatology
sites that became active during the data collection
period of the study.
Project aims
 To explore acceptability of teledermatology to
patients, nurses, GPs and dermatologists
 To explore patients’ level of satisfaction with
teledermatology
 To explore the possible impact of telemedicine
consultations on the care pathway
 To develop an evaluation model that can be
applied to all telemedicine services.
General Practitioner (GP) survey
 45 questionnaires were sent to all GPs who
referred patients to teledermatology at 12
practices. 18 questionnaires were completed,
(40% response rate).
 Almost 90% of respondents thought that
telemedicine provided a quicker diagnosis, with
50% strongly agreeing.
 57% were confident that the diagnosis would
be “as good as” that arising from a face-to-face
consultation, and 33% were uncertain.
 57% were confident that patient management
would be “as good as” face-to-face consultations
and 44% were uncertain.
IMSCaR
Institute of Medical and Social Care Research (IMSCaR), University of Wales, Bangor
Just one GP agreed with the statement “I think that the
consultant should see every patient in person”.

Methods
Questionnaires and interviews were used to elicit
views of staff, patients and GPs about
teledermatology. In addition, routinely collected
activity data was used to analyse patient contact
with the service.
Quantitative findings
 There were 137 referrals (of 136 patients) for
teledermatology consultations with a consultant
dermatologist in a 12-week time period.
 55 patients (40%) referred for teledermatology
were diagnosed, prioritised and triaged within 24
hours of referral, 83% within 7 days and 97% within
21 days.
 Teledermatology obviated 75 face-to-face
consultations with a consultant dermatologist in a
12-week time period, (55% of the patients referred).
 Figure 1 shows the distribution of postteledermatology consultation patient pathways.
Figure 1:
Post- teledermatology consultation patient
pathways
urgent rash
Urgent
rash
3%
3%
urgent lesion
Urgent
7%
lesion
7%
46% referred
for face-toface
consultation
with a
dermatology
consultant
broken down
by condition
routine
rash
Routine
to GP
ReferRefer
to GP
26%
26%
rash
14%
14%
routine lesion
Routine
lesion
22%
22%
Minor surgery
Minor
surgery
28%
28%
Patient survey
 All patients referred to teledermatology in an 8-week
period were invited to participate. 39 patients returned
questionnaires (32% response rate).
 Of the patients who expressed an opinion, 41%
preferred to see the dermatologist in person.
 97% preferred that their skin problem was managed
using telemedicine, rather than have to wait a few months
to see the dermatologist.
 97% of patients were satisfied with the teledermatology
consultation.
 Only one patient reported the need to be re-referred for
a face-to-face consultation to establish an accurate
diagnosis.
Staff survey
 Staff involved in the project
demonstrated an underlying
enthusiasm and a willingness
for the implementation of
telemedicine in North Wales
to be successful.
Conclusion
This appears to be a promising innovation that requires
ongoing evaluation. Analysis of the views expressed by
key stakeholders, namely patients, GPs and NHS staff,
indicates that:
 GPs view teledermatology as an effective way of
accessing the dermatologist’s opinion
 patients are satisfied with the service
 all key stakeholders find that it is an acceptable method
of prioritising referrals
 nurses have gained new expertise in dermatology, in
setting up and managing an innovative clinic, increased
contact with patients and an increased interest in pursuing
further education and training.
Further details:
This project was funded by the North Wales E-Health Consortium
Please contact [email protected] for the full project report
for the Welsh Assembly Government