Teledermatology for Enhancing Skin Cancer Diagnosis and Management: Retrospective Chart Review

Area of Science:

• Dermatology
• Teledermatology
• Health Informatics

Background:

• Rising skin cancer incidence necessitates improved diagnostic pathways.
• Shortage of dermatologists increases reliance on general practitioners for skin lesion assessment.
• The Suspected Skin Cancer (SSC) service was established in Waikato, New Zealand, to expedite diagnosis and treatment advice for suspicious skin lesions.

Purpose of the Study:

• To evaluate the volume, quality, and characteristics of referrals to the SSC teledermatology service.
• To assess the effectiveness of the SSC service in its initial 6 months of operation.

Main Methods:

• Retrospective review of 340 referrals for 402 lesions submitted to the SSC service over 6 months.
• Analysis of diagnostic discordance between general practitioners, dermatologists, and pathologists.
• Recording of time to dermatological advice and time to treatment initiation.

Main Results:

• Dermatologists diagnosed 63.7% of lesions as benign and 13.9% as malignant (including 4.7% melanomas).
• Significant diagnostic discordance observed between general practitioners and specialists (up to 47%).
• Mean time to advice was 1.02 days, with an average time to action of 64.8 days.

Conclusions:

• The electronic referral system (SSC service) provides effective teledermatology for prompt diagnosis and management of skin lesions.
• The service facilitates timely advice for both benign and malignant skin conditions.
• Addressing diagnostic discrepancies is crucial for optimizing patient care pathways.