Evaluation of a Telehealth Clinic as a Means to Facilitate Dermatologic Consultation: Pilot Project to Assess the Efficiency and Experience of Teledermatology Used in a Primary Care Network

Background: Primary care offices spend considerable time coordinating the specialist referral process. Patients experience long wait times for consultation and intervention. Objective: To determine if telehealth combined with interdisciplinary team–based care can reduce wait times for dermatologic c...

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Bibliographic Details
Published in:Journal of cutaneous medicine and surgery 2010-01, Vol.14 (1), p.7-12
Main Authors: Ludwick, David A., Lortie, Charles, Doucette, John, Rao, Jaggi, Samoil-Schelstraete, Christine
Format: Article
Language:English
Subjects:
Alberta
Biological and medical sciences
Dermatology
Dermatology - methods
Efficiency, Organizational
Female
Health services
Humans
Interviews as Topic
Male
Medical sciences
Middle Aged
Pilot Projects
Primary care
Primary Health Care
Remote Consultation
Retrospective Studies
Studies
Telemedicine
Waiting Lists
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Summary:Background: Primary care offices spend considerable time coordinating the specialist referral process. Patients experience long wait times for consultation and intervention. Objective: To determine if telehealth combined with interdisciplinary team–based care can reduce wait times for dermatologic consultation while making the consultation process easier for physicians. Methods: Retrospective chart reviews as well as patient, referring physician, nonreferring physician, clinic physician, nurse, and teledermatologist interviews were used to evaluate the clinic. A comparative immersion approach generated themes from field notes. Wait times, appointment times, and encounter durations were measured. Results: Twenty-eight patients were seen (23 had previous specialist referral experience) within 1 week of referral compared to a wait period of 104 days for conventional referral. Patients requiring intervention were treated within 1 week of their initial appointment. Referring practitioners were concerned that they would lose control of patients' care. An easier referral process and faster intakes met physician expectations. Conclusions: Teledermatology improves the timeliness of appointments. Patients forgo face-to-face appointments if alternatives are available sooner. Physicians are concerned about their own liability if dermatologists do not assess the patient in person but will refer through teledermatology when patients are seen faster and they remain in control of the care process.
ISSN:1203-4754
1615-7109
DOI:10.2310/7750.2010.09012