Objective

Comment

Improve patient experience

Controversial. Probably depends on how teledermatology is used, the geography and what is wrong with patient. Saving long journeys is of more value than short journeys, but those with morbidity from rashes may prefer to come for consultation at hospital.

Help GPs

System needs to be streamlined and easy to make it of help to them. Using it as a supplement to the telephone to obtain advice may be more help than trying to use it as a substitute for consultation.

Reduce waiting lists

If "new" staff run the service, then in the short run it is likely reduce the time to first visit. If current staff diversify to teledermatology there is no evidence that this affects the waiting list. However, it may alter the experience or wait of individual patients.

Teledermatology generates follow ups if it is used as a substitute for consultation; 13-60%. 40-80% of patient referrals are thought eligible for teledermatology consultation.

Provide guidance on management whilst on the waiting list

This can work and may mean that the patient does not need to be seen when their appointment comes. There is currently no evidence on this and it requires continuing involvement of GP in process.

Triage patients to ensure appropriate priority

There are several studies to show that an image will alter the priority to a referral – mostly reducing the priority where it is difficult to interpret a letter. The cost taken to triage can be combined with the benefit of advice to patient. Otherwise cost benefit of triage is difficult to calculate due to clinical time taken to triage.

Fulfil political objectives

The equipment provided for teledermatology can be useful for a range of activities. Once in place, services evolve, thrive or fail. Many of the facts contributory to these possible outcomes are obvious, but are worth considering before hand.