Practising dermatology via telemedicine

An interactive telemedicine service has been established between Taumarunui Hospital and the Department of Dermatology at Waikato Hospital. The first one hundred dermatological consultations were reviewed to see if the consultations were satisfactory for medical staff and patients.

A proprietary video conferencing system communicating via the Integrated Systems Digital Network was used to conduct dermatological consultations. Data were collected regarding waiting time, diagnosis and follow-up arrangements. Each patient was asked to complete a questionnaire after the consultation.

Of these consultations, 83 were newly referred patients and the rest were follow-ups. The median waiting time for a new patient was 63 days. A variety of skin lesions (in 40 patients), inflammatory eruptions (31) and infections (13) were diagnosed and managed. Sixteen patients had to be seen at the base hospital for surgical treatment (7), face-to-face diagnosis (3), patch testing (3), a second opinion (2), or for personal reasons (1). The others were followed up locally. Savings in time and cost to patients were noted particularly.

Only about 20% of consultations with new patients resulted in a further face-to-face appointment. The majority of patients found the telelink acceptable. The data supported the continuation and possible expansion of the dermatology telemedicine service. However, improved image quality is desirable.