Mobil teledermatologi för remittering av patienter med allmänna hudsjukdomar (exklusive hudcancer)

Abstract

Degree Project Thesis, Programme in Medicine. TITLE: Mobile teledermatology for referral of patients with common skin diseases (excluding skin tumors). Background Dermatology clinics around Sweden face increasing pressure. Patients with skin diseases are traditionally referred from the general practitioner to the dermatologist by a text-based paper referral without photo documentation. Mobile teledermatology, implying electronic referral including digital images by the use of mobile technology, offers an alternative way of referral and has been the subject of much research recently. Objective The current study aimed to evaluate the overall management of patients with common skin diseases referred to a dermatologist by means of comparing mobile teledermatology referral to standard paper referral. Method The study was conducted in a prospective observational manner where, after definitive exclusion, the clinical outcome and triage results of an intervention group consisting of 205 patients referred via mobile teledermatology were compared to a control group consisting of 239 patients referred by paper referral. Results Our main findings are that the time to diagnosis and treatment effectively can be reduced from 128 and 120 days, respectively, to 10 days with mobile teledermatology. Furthermore, a 28% reduction in patients not needing a face-to-face visit with a dermatologist could be achieved. Among the 63 patients given no priority (30.7%), only one incorrect assessment was made (1.6 %). In addition, our results attribute a diagnostic accuracy of 84 % to mobile teledermatology. Concluding remarks Mobile teledermatology can substantially reduce the number of face-to-face visits with a dermatologist and can also reduce the waiting time for referred patients to receive effective treatment via the general practitioner. Key words: Mobile teledermatology, smartphone, referral, management