Clinical outcomes and operational impact of a medical photography based teledermatology service with over 8,000 patients in the UK

Abstract

A new, store-and-forward, fully digitised Teledermatology (TD) pathway was designed and implemented in an urban setting for non-two-week wait routine patients. In total 8,352 new patients had a TD consultation over 37 months. Of these, 4,748 (56.8%) were referred back to their GP, 1,634 (19.6%) were referred directly for a surgical procedure and 1,970 (23.6%) for a face-to-face review with a Dermatologist (F2F). The average waiting time for a TD appointment was 3 vs. 30 weeks for a routine F2F appointment. Between 2019 and 2018, TD referrals rose by 38%, routine dermatology referrals reduced by 16% and cancer referrals increased by 6%. Using medical photographers proved to be effective with only two cases (0.02%) of images being of insufficient quality to form a clinical opinion. Hitherto, savings for the local Commissioning Groups were estimated at £671,218. Last financial year savings (2019–2020) were £284,671. The average cost savings per TD patient appointment was £80.36. Savings in the Trust’s overhead costs were £53,587. TD consultants reviewed almost twice the number of patients vs. F2F for the same amount of consultant programmed activities. 95% of surveyed patients would be likely or extremely likely to recommend this service to friends and family.

Keywords:

• Teledermatology
• medical-photography
• model
• teledermatoscopy
• dermatology

Acknowledgements

The authors would like to thank David Bishop, Jayne Noctor and Rosie Hallam, part of the medical photography team and Drs. Janet High and Mike Wyndham, lead GPs for their commitment, support and help in establishing this service. Also Ms Helen Makari for her help in the finance modelling.

Disclosure statement

No potential conflict of interest was reported by the authors.