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

Abstract

BackgroundIn developed countries, health care delivery in dermatology is hampered by the low availability of dermatologists.ObjectiveTo analyze the feasibility of a teledermatology-based action plan to provide initial dermatologic care in areas with low availability of dermatologists.MethodsA 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.ResultsAmong 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.LimitationsNoncontrolled study.ConclusionsExperienced dermatologists working with store-and-forward TD can deliver a fast and effective response in health care areas with access limitations.