A feasibility study of realtime teledermatology in Finland.

We conducted a feasibility study of teleconsultation in dermatology using low-cost equipment. Patients and their general practitioners took part in consultations from the Primary Health Care Centre in Ikaalinen with a dermatologist 55 km away at the Tampere University Hospital (TAUH). Consultations were performed using standard commercial videoconferencing equipment, a modified document camera and a dermatoscope. A single ISDN line (128 kbit/s) was used for the connection. During the eight months of the study, 25 patients participated in a teledermatology consultation. Their mean age was 45 years (range 4-92). The average time the patient spent in travelling to the videoconsultation (i.e. one way) was 24 min (range 5-65 min). The mean time spent in the teleconsultation was 15 min (range 5-30 min). After the teleconsultation, patients' treatments changed in 19 cases (76%), diagnoses were changed in 13 cases (52%) and 18 patients (72%) did not need to go to the TAUH. The equipment was generally reliable and easy to use. However, the dermatoscope was not very useful and only one of the consultations relied mainly on it. The cost of the teleconsultations for the 18 patients who avoided travel to the TAUH was FM18,627. The total costs for the 18 conventional consultations in the TAUH would have been FM18,034. The main economic benefits of the videoconferencing were attributable to the reduced travelling and hospital costs. The economic benefits of medical education were more difficult to quantify.