Patient Pathway

Where do they have the image and healthcare undertaken

Options include:

• At the desk with their own GP
• By arrangement with a further member of the GP group practice
• By a peripatetic teledermatology nurse - possibly in specified teledermatology primary care setting
• Tissue viability nurses, district nurses and doctors undertaking consultations as part of home care or domiciliary visits can all use teledermatology with potential benefit

Are consultations reduced or increased: with who?

Currently, numbers of consultations have been measured only with the dermatologist. As a triage tool it makes no difference to numbers of consultations.

It is not clear whether total consultations for the patient will be reduced with all models of teledermatology. It is possible that consultations with the GP may be increased

How often is consultation duplicated because of shortcomings in teledermatology?

13-60% of patients still come to dermatology outpatients after teledermatology. This is after the preselection of cases for the service. ie counselling, cases with symptoms, possible melanomas, have all been excluded. Reasons for review in the dermatology clinic are likely to be:

• Inability to diagnose/construct treatment plan with teledermatology
• Need for hospital investigations or treatments
• Need for full discussion with patient