[Development and challenges of teledermatology in Spain: A study of primary care practice]

This study evaluated the use, problems, and satisfaction with teledermatology among Primary Care physicians in Spain, analyzing the delay in referrals to Dermatology and the differences between autonomous communities.

A cross-sectional study was conducted through a pilot survey of 102 Primary Care physicians, members of Spanish Society of Rural and General Medicine (SEMERGEN), from different Autonomous Communities. The survey, agreed upon by SEMERGEN and the Spanish Association of Dermatology and Venereology (AEDV), included open-ended and closed-ended questions and was distributed via newsletter and WhatsApp. Statistical analysis was performed using R version 4.2.1, summarizing categorical variables as frequencies/percentages and numerical variables as medians/interquartile ranges.

39,2% of professionals use teledermatology in their daily practice, with asynchronous (store-and-forward, 49%) being the most prevalent, especially in rural areas and nursing homes. 68.6% of professionals rated their satisfaction with teledermatology at 7 or more out of 10. The main problems identified were lack of training (44.1%), delays of more than 60days in the in-person consultation (58.8%), and lack of coordination between Primary Care and Dermatology (41.8% in urban areas). Screening and prioritizing patients with suspected skin cancer (72.5%) and shared decision-making with the dermatologist (64.7%), as well as improved access in rural areas, which was significantly higher (48.6%; P<.001), were the most frequently cited objectives. The most common barriers were image quality, the use of personal devices, and legal concerns about data protection.

Teledermatology is a well-established and valued tool in Primary Care, especially useful in rural areas and for the management of skin cancer. However, challenges remain, such as the need for ongoing training, improved image quality, and greater coordination between levels of care. Professional satisfaction is high, but the delay in in-person referrals and regional variability require organizational and collaborative interventions with the AEDV and regional health services. SEMERGEN and the AEDV should promote training strategies and legal/technical advice to optimize teledermatology in Spain.