Just one GP agreed with the statement “I think that the consultant should see every patient in person”.

Patient survey All patients referred to teledermatology in an 8-week period were invited to participate. 39 patients returned questionnaires (32% response rate). Of the patients who expressed an opinion, 41% preferred to see the dermatologist in person. 97% preferred that their skin problem was managed using telemedicine, rather than have to wait a few months to see the dermatologist. 97% of patients were satisfied with the teledermatology consultation. Only one patient reported the need to be re-referred for a face-to-face consultation to establish an accurate diagnosis.

Staff survey Staff involved in the project demonstrated an underlying enthusiasm and a willingness for the implementation of telemedicine in North Wales to be successful.

ConclusionThis appears to be a promising innovation that requires ongoing evaluation. Analysis of the views expressed by key stakeholders, namely patients, GPs and NHS staff, indicates that: GPs view teledermatology as an effective way of accessing the dermatologist’s opinion patients are satisfied with the service all key stakeholders find that it is an acceptable method of prioritising referrals nurses have gained new expertise in dermatology, in setting up and managing an innovative clinic, increased contact with patients and an increased interest in pursuing further education and training.

Further details:Please contact p.linck@bangor.ac.uk for the full project report

IMS

CaR

IMS

CaR

This project was funded by the North Wales E-Health Consortium for the Welsh Assembly Government

General Practitioner (GP) survey 45 questionnaires were sent to all GPs who referred patients to teledermatology at 12 practices. 18 questionnaires were completed, (40% response rate). Almost 90% of respondents thought that telemedicine provided a quicker diagnosis, with 50% strongly agreeing. 57% were confident that the diagnosis would be “as good as” that arising from a face-to-face consultation, and 33% were uncertain. 57% were confident that patient management would be “as good as” face-to-face consultations and 44% were uncertain.

EARLY EVALUATION OF EARLY EVALUATION OF TELEDERMATOLOGY TELEDERMATOLOGY IN RURAL NORTH WALESIN RURAL NORTH WALES

Pat Linck, Rhiannon Tudor Edwards, Bruce Napier and Catherine Robinson

Institute of Medical and Social Care Research (IMSCaR), University of Wales, Bangor

Project objective To conduct a service evaluation of existing teledermatology services and new teledermatology sites that became active during the data collectionperiod of the study.

Project aims To explore acceptability of teledermatology to patients, nurses, GPs and dermatologists To explore patients’ level of satisfaction with teledermatology To explore the possible impact of telemedicine consultations on the care pathway To develop an evaluation model that can be applied to all telemedicine services.

Methods Questionnaires and interviews were used to elicit views of staff, patients and GPs about teledermatology. In addition, routinely collected activity data was used to analyse patient contact with the service.

Quantitative findings There were 137 referrals (of 136 patients) for teledermatology consultations with a consultant dermatologist in a 12-week time period. 55 patients (40%) referred for teledermatology were diagnosed, prioritised and triaged within 24 hours of referral, 83% within 7 days and 97% within 21 days. Teledermatology obviated 75 face-to-face consultations with a consultant dermatologist in a 12-week time period, (55% of the patients referred). Figure 1 shows the distribution of post- teledermatology consultation patient pathways.

3%

7%

14%

22%

28%

26%

urgent rash

urgent lesion

routine rash

routine lesion

Minor surgery

Refer to GP

Routine lesion 22%

Urgent rash 3%

Urgent lesion 7%

Routine rash 14%

Minor surgery 28%

Refer to GP 26%

Figure 1: Post- teledermatology consultation patient pathways

46% referredfor face-to-faceconsultation with a dermatology consultant broken down by condition