1 Department of Dermatology, Emory University School of Medicine , Atlanta, Georgia .
Telemed J E Health. 2013 Oct;19(10):780-5. doi: 10.1089/tmj.2012.0260.
To determine whether teledermatology referrals yield a shorter time to biopsy of the most common types of skin cancer versus conventional dermatology referrals.
A retrospective chart review was performed of California's Central Valley Kaiser Permanente conventional dermatology or teledermatology referrals that yielded a positive skin cancer biopsy over a 7-month period. Four primary care clinics at Kaiser Permanente's Stockton Medical Center in California's Central Valley were included. Patients who were studied were treated for squamous cell carcinoma of skin, basal cell carcinoma of skin, and malignant melanoma. We compared the time interval between initial evaluation and biopsy of the most common types of skin cancer for teledermatology versus traditional referrals from primary care.
Our study criteria were met by 293 patient cases (58% conventional referrals and 42% teledermatology referrals). The mean time to biopsy of skin cancer was 13.8 days for conventional referrals (median, 12.0 days) versus a mean of 9.7 days (median, 9.0 days) for teledermatology referrals (p<0.0001).
The use of teledermatology in remote areas results in a shorter time to biopsy than traditional referral methods as a result of improved triaging measures.
确定远程皮肤病学转诊是否比传统皮肤病学转诊更能缩短常见皮肤癌类型的活检时间。
对加利福尼亚州中央山谷 Kaiser Permanente 的传统皮肤病学或远程皮肤病学转诊进行了回顾性图表审查，这些转诊在 7 个月的时间内产生了阳性皮肤癌活检结果。该研究纳入了加利福尼亚州斯托克顿 Kaiser Permanente 医疗中心的 4 个初级保健诊所。接受研究的患者患有皮肤鳞状细胞癌、皮肤基底细胞癌和恶性黑色素瘤。我们比较了远程皮肤病学与传统初级保健转诊之间最常见类型皮肤癌的初始评估与活检之间的时间间隔。
我们的研究标准符合 293 例患者病例（58%为传统转诊，42%为远程皮肤病学转诊）。传统转诊的皮肤癌活检平均时间为 13.8 天（中位数为 12.0 天），而远程皮肤病学转诊的平均时间为 9.7 天（中位数为 9.0 天）（p<0.0001）。
远程皮肤病学在偏远地区的使用由于分诊措施的改善，导致活检时间比传统转诊方法更短。
