The Teledermatology Experience: Cost Savings and Image Quality Control

Area of Science:

• Dermatology
• Health Informatics
• Health Services Research

Background:

• Teledermatology adoption is rising, accelerated by the COVID-19 pandemic.
• The Veterans Health Administration (VA) utilizes store-and-forward teledermatology for remote consultations.
• Previous studies highlight the potential of digital health solutions in dermatology.

Purpose of the Study:

• To evaluate the diagnostic utility of a store-and-forward teledermatology system in the VA.
• To assess the cost savings associated with this teledermatology program.
• To analyze the concordance between teledermatology and in-person dermatological evaluations.

Main Methods:

• Retrospective cohort study of 4,493 patients across 14 remote VA sites (May 2017-August 2019).
• Comparison of teledermatology diagnoses with follow-up face-to-face evaluations.
• Analysis of cost-effectiveness, including community care cost savings.

Main Results:

• High concordance between teledermatologist and clinic dermatologist diagnoses for pre-malignant and malignant conditions.
• 54% of patients were recommended for face-to-face appointments; 80.5% received care from VA dermatologists.
• Teledermatology resulted in $1,076,000 in savings for the VA system by reducing community care costs.
• Veterans experienced faster care within VA clinics compared to community sites.

Conclusions:

• Teledermatology is a valuable diagnostic tool within the VA healthcare system.
• The implemented system demonstrates significant cost savings for the VA.
• This approach enhances the efficiency and accessibility of dermatological care for veterans.