Blum Andreas, Haase Sylvie, Barlinn Stefanie, Kopplin Diana, Neher Stephan, Ott Nanette, Ottinger Maximilian, Ridder Jörn, Seifert-Ibach Christiane, Witzel Achim, Zantl Petra, Eber Elena, Hofmann-Wellenhof Rainer
Hautarztpraxis Blum & Haase, Augustinerplatz 7, 78462, Konstanz, Deutschland.
Hausarztpraxis Ott, Konstanz, Deutschland.
Hautarzt. 2020 Jul;71(7):535-541. doi: 10.1007/s00105-020-04584-5.
There is an increasing need by general practitioners (GPs) for consultations regarding skin diseases or skin lesions. Teledermatological and teledermoscopic diagnoses are possible with good results.
This descriptive study analyzed whether the increasing need for dermatological consultations could be improved by regional teledermatological and teledermoscopic triage between GPs and dermatologists.
Via an internet platform, six GPs sent images of unclear skin diseases or skin lesions to a dermatology practice (2 dermatologists) over a period of 9 months. Possible triage answers were (1) stay at the GP, (2) urgent consultation at the dermatologist (days), or (3) later (week/months) consultation at the dermatologist, respectively, with the diagnosis and therapeutic suggestions. A feedback (grade 1-6) were given by the dermatologists about the image quality and from the GPs about the appraisal. The dermatologists' appraisals were done independently and were audited by a third dermatologist.
The patients' acceptance was 100% and a very good to good image quality was achieved in 94%; 66.3% of patients could stay at their GP and 20.7% of patients should come urgently to the dermatologist. The teletriage decisions of an urgent consultation at the dermatologist were confirmed in 41.5%. The GPs' feedback about the teletriage appraisal received an overall average grade of 1.1.
Successful regional teledermatological and teledermoscopic triage between GPs and dermatologists is possible. Specifications on data privacy laws must be followed and an appropriate remuneration is preferable.
全科医生（GP）对皮肤病或皮肤病变会诊的需求日益增加。远程皮肤病学和远程皮肤镜诊断是可行的，且效果良好。
本描述性研究分析了全科医生与皮肤科医生之间通过区域远程皮肤病学和远程皮肤镜分诊，是否可以改善对皮肤科会诊日益增长的需求。
通过一个互联网平台，6名全科医生在9个月的时间里将不明皮肤病或皮肤病变的图像发送给一家皮肤科诊所（2名皮肤科医生）。可能的分诊答案分别为：（1）留在全科医生处；（2）紧急会诊皮肤科医生（数天内）；（3）稍后（数周/数月后）会诊皮肤科医生，并给出诊断和治疗建议。皮肤科医生对图像质量给出反馈（1 - 6级），全科医生对评估给出反馈。皮肤科医生的评估是独立进行的，并由第三位皮肤科医生审核。
患者接受率为100%，94%的图像质量非常好或良好；66.3%的患者可以留在全科医生处，20.7%的患者应紧急前往皮肤科医生处。皮肤科医生紧急会诊的远程分诊决定在41.5%的情况下得到确认。全科医生对远程分诊评估的反馈总体平均评分为1.1。
全科医生与皮肤科医生之间成功进行区域远程皮肤病学和远程皮肤镜分诊是可行的。必须遵循数据隐私法的规定，并且最好有适当的报酬。
