Teledermatología. Capacidad para reducir consultas presenciales según el grupo de enfermedad

IntroductionTeledermatology was initially considered useful and cost-effective, especially when distances to the reference hospital were significant. It is currently gaining importance as a more specific tool that can evaluate the need for a rapid referral or to decrease medical costs. The aim of this study was to assess the capacity of teledermatology for resolving cases in different groups of disease.Material and methodsTeleconsultations received in our Department of Dermatology between May 2011 and April 2014 were evaluated according to the virtual diagnosis, the indication given by the dermatologist who evaluated the teleconsultation (discharge/referral), reasons for attending to hospital, reasons for more than one virtual consultation, final face-to-face diagnosis, and diagnostic agreement between the virtual and face-to-face diagnoses.ResultsAn assessment was made on 1163 virtual consultations. Inflammatory diseases were the most frequent diagnosis group (45%). A total of 50.82% of virtual consultations were discharged. The highest resolution rate was achieved by the infectious diseases group, followed by inflammatory diseases (78.4% and 62.8%, respectively). Malignant lesions were referred in nearly all cases (96.7%). The main reason for a referral was the need for diagnostic confirmation or complementary studies (59.8% of all cases). A total of 102 patients received more than one teleconsultation, principally due to incomplete clinical data or poor-quality images. The agreement rate between virtual and face-to-face diagnosis was 88.95%.ConclusionTeledermatology avoids around 50% of the primary care referrals. The highest resolution rate is achieved in the infectious diseases group, followed by the inflammatory diseases group and, secondly, by benign tumours and benign melanocytic lesions.