Teleconsultation Actions in Reducing In-Person Referrals for Oral Lesions: A Scoping Review

This scoping review aimed to investigate the impact of teleconsultation actions on the reduction of unnecessary referrals for specialized in-person care of oral lesions.

This review included studies on teleconsultation in oral medicine and oral pathology that presented data on the referral flow for in-person care. Teleconsultation modalities included synchronous, asynchronous, or unspecified interactions. Excluded from the review were: (1) reviews, clinical cases, letters, chapters, conference abstracts, and editorials; (2) studies on direct teleconsultation between professionals; (3) telemanagement interventions; and (4) tele-education initiatives.

Nine articles met the inclusion criteria. The asynchronous teleconsultation stands out as the most effective intervention for reducing in-person referrals, observed in eight studies. Referral reductions ranged from 37.3% to 80%, with five studies exceeding 50%. Primary healthcare dentists were the most frequent users of the teleconsultation platform. The most commonly identified lesions found were oral potentially malignant disorders and soft tissue tumors.

Asynchronous teleconsultation may reduce referrals for in-person care, though evidence is limited. Notably, referral rates exhibited significant heterogeneity across studies. Low reduction rates may be attributed to the high proportion of cases requiring in-person assessment. Future research should focus on optimizing referral reduction while addressing the heterogeneity of outcomes.