Commercial mobile teledermatology – A solution for everyone?

Abstract

Abstract BACKGROUND: With skin cancers being among the fastest growing cancers in Sweden, it has lead to increased pressure on dermatology clinics everywhere in the country. Standardized care processes have improved the situation regarding malignant melanoma and squamous cell carcinoma, however general dermatologic issues remain. Several studies have been made on teledermatology, many of them with promising results such as shortened time to treat, unnecessary visits skipped, planning easier and triaging possible. A logical evolution of teledermatology is a mobile form, mobile teledermatology. Studies have been made on this as well, however results not as precise as the regular form, although it has been suggested to work as a tool for triaging. AIM: To investigate whether a direct to consumer mobile teledermatology system can triage users correctly to the nearest dermatology clinic for further tests, diagnosing and the right treatment and save time. METHOD: In 2017, 766 patients used a teledermatology application, out of these 262 were recommended to use the application to send a self-referral to nearest dermatology clinic, 105 users sent a self-referral through this application, these were followed up. For comparison 120 primary healthcare center referrals and 120 regular self-referrals were obtained. The priorities given to each referral were compared, time until first visit in days within each assessment and specific diagnoses, and as well time until treatment were compared. RESULTS: The difference in distribution of assessments was statistically significant when the teledermatology self-referrals were compared with regular self-referrals. The difference remained statistically significant when all three groups were compared. There was a statistically significant difference in days waited between all three groups when prioritized as 2-4 weeks and 1-3 months, however this only implies that there was a significant difference in waiting times between all three groups. Thus teledermatology referrals were compared separately to each group, and days waited were only significantly lower compared to primary healthcare referrals in 2-4 weeks priority. However there were no statistically significant difference in days waited was found in any other priorities or diagnoses between the groups. CONCLUSION: From data obtained, using a mobile teledermatology application may lower the amount of rejected referrals and at the same time find patients with lesions in more need of specialist care. Patients with regular self-referrals got an appointment faster than all other groups of all priorities analyzed however these type of referrals were rejected the most as well. The teledermatology referrals had slightly longer waiting times with a lower percentage of rejected referrals, although a significant difference was only found in one priority (2-4 weeks).