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伦敦一家三级皮肤病中心用于评估孤立性皮肤病变的试点远程皮肤病学服务

Pilot Teledermatology Service for Assessing Solitary Skin Lesions in a Tertiary London Dermatology Center.

作者信息

Cheung Chung-Mei Maggie, Muttardi Kayria, Chinthapalli Suchitra, Ismail Ferina

出版信息

J Healthc Qual. 2019 Jan/Feb;41(1):e1-e6. doi: 10.1097/JHQ.0000000000000142.

Abstract

BACKGROUND

Efficient clinical pathways are needed to meet the growing pressures in dermatology due to the significant rise in the number of suspected skin cancer referrals. Our hospital serves a wide geographical area and receives a large number of 2-week-wait (2WW) suspected skin cancer referrals. In the United Kingdom, approximately 10-12% of 2WW referrals are diagnosed as skin cancers fulfilling the 2WW criteria.

PURPOSE

We sought to assess the role of teledermatology in reducing hospital consultations for patients referred via the dermatology 2WW pathway.

METHODS

We piloted a teledermatology service and detailed the clinical outcomes of patients with solitary skin lesions of uncertain diagnosis triaged through this pathway. Seventy-six primary care referrals were reviewed by consultant dermatologists and analyzed against the British Association of Dermatologists' teledermatology audit standards.

RESULTS

In 52/76 (68%) of patients, confident benign diagnoses were made, avoiding the need for a face-to-face (FTF) consultation.

CONCLUSIONS

Our results showed that with adequate image quality, teledermatology can be used to accurately diagnose skin lesions.

IMPLICATIONS

Teledermatology can significantly reduce the number of urgent referrals necessitating FTF appointments, therefore providing a new solution to streamline care delivery.

摘要

背景

由于疑似皮肤癌转诊数量显著增加,皮肤科面临着越来越大的压力,因此需要高效的临床路径。我们医院服务于广泛的地理区域,接收大量两周等待(2WW)疑似皮肤癌转诊患者。在英国,约10 - 12%的两周等待转诊患者被诊断为符合两周等待标准的皮肤癌。

目的

我们旨在评估远程皮肤病学在减少通过皮肤科两周等待路径转诊患者的医院会诊方面的作用。

方法

我们试行一项远程皮肤病学服务,并详细记录了通过该路径分诊的诊断不明的孤立性皮肤病变患者的临床结果。76例初级保健转诊患者由皮肤科顾问医生进行了评估,并对照英国皮肤科医师协会的远程皮肤病学审核标准进行了分析。

结果

52/76(68%)的患者得到了明确的良性诊断,无需进行面对面(FTF)会诊。

结论

我们的结果表明,在图像质量足够的情况下,远程皮肤病学可用于准确诊断皮肤病变。

意义

远程皮肤病学可显著减少需要面对面预约的紧急转诊数量,从而为简化医疗服务提供一种新的解决方案。

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