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      A cost savings analysis of asynchronous teledermatology compared to face-to-face dermatology in Catalonia

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          Abstract

          Background

          A teledermatology pilot scheme was first conducted in the town of Manresa (Barcelona) in the summer of 2010. The clinical success of the scheme prompted its expansion to the whole county of Bages in 2011 and to the adjacent county of Berguedà in 2012.

          In the teledermatology service, primary care physicians take a photograph of the lesion and attach it to the electronic medical records of the patient together with a brief clinical account. In the referral hospital, the consultant dermatologists access the electronic medical records, review the images and suggest a treatment or action plan. Next, the primary care physicians review these recommendations and call the patient to report the results. This whole process is usually completed in less than 5 working days.

          Methods

          A cost saving analysis comparing teledermatology with dermatology face-to-face visits was performed in the county of Bages measuring the cost difference attributable to visits saved.

          Results

          The estimated added costs of the teledermatology service during 2016 amounted to 61,870 €. For the same period, the estimated costs of traditional outpatient dermatology services were of 113,034 €. This represents savings of 51,164 € per year. After subtraction of societal costs, the savings equal 10,350 € per year.

          Conclusions

          Using a teledermatology service instead of face-to-face dermatology consultations could save 51,164 € per year (11.4 € per patient visited) in the county of Bages. Societal savings are the most significant.

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          Most cited references9

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          Telemedicine technology and clinical applications.

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            Teledermatology: from historical perspective to emerging techniques of the modern era: part I: History, rationale, and current practice.

            Telemedicine is the use of telecommunications technology to support health care at a distance. Technological advances have progressively increased the ability of clinicians to care for diverse patient populations in need of skin expertise. Dermatology relies on visual cues that are easily captured by imaging technologies, making it ideally suited for this care model. Moreover, there is a shortage of medical dermatologists in the United States, where skin disorders account for 1 in 8 primary care visits and specialists tend to congregate in urban areas. Even in regions where dermatologic expertise is readily accessible, teledermatology may serve as an alternative that streamlines health care delivery by triaging chief complaints and reducing unnecessary in-person visits. In addition, many patients in the developing world have no access to dermatologic expertise, rendering it possible for teledermatologists to make a significant contribution to patient health outcomes. Teledermatology also affords educational benefits to primary care providers and dermatologists, and enables patients to play a more active role in the health care process by promoting direct communication with dermatologists.
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              An assessment of the cost-effectiveness, safety of referral and patient satisfaction of a general practice teledermatology service

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                Author and article information

                Contributors
                00 34 693 00 40 , jvidal.cc.ics@gencat.cat
                Journal
                BMC Health Serv Res
                BMC Health Serv Res
                BMC Health Services Research
                BioMed Central (London )
                1472-6963
                22 August 2018
                22 August 2018
                2018
                : 18
                : 650
                Affiliations
                [1 ]ISNI 0000 0000 9127 6969, GRID grid.22061.37, Health Promotion in Rural Areas Research Group (PRoSaARu), Gerència Territorial de la Catalunya Central, Catalan Health Institute, ; Carrer Pica d’Estats, 36, 08272 Sant Fruitós de Bages, Barcelona Spain
                [2 ]GRID grid.452479.9, Unitat de Suport a la Recerca de la Catalunya Central, , Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), ; Barcelona, Spain
                [3 ]GRID grid.440820.a, Department of Economics and Business, , University of Vic- Central University of Catalonia, ; Vic, Barcelona Spain
                [4 ]GRID grid.7080.f, General Surgery Department, , Autonomous University of Barcelona, ; Barcelona, Spain
                [5 ]GRID grid.440820.a, Chair in ICT and Healthcare, , University of Vic-Central University of Catalonia, ; Vic, Barcelona Spain
                [6 ]Xarxa Sanitària i Social de Santa Tecla, Tarragona, Spain
                Author information
                http://orcid.org/0000-0002-3527-4242
                Article
                3464
                10.1186/s12913-018-3464-4
                6103877
                30134891
                22359b93-bcf8-4689-b539-33ba8e2b4eef
                © The Author(s). 2018

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 13 November 2017
                : 13 August 2018
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2018

                Health & Social care
                teledermatology,telemedicine,telehealth,cost savings analysis,primary care
                Health & Social care
                teledermatology, telemedicine, telehealth, cost savings analysis, primary care

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