A feasibility study of realtime teledermatology in Finland

We conducted a feasibility study of teleconsultation in dermatology using l ow-cost equipment. Patients and their general practitioners took part in co nsultations from the Primary Health Care Centre in Ikaalinen with a dermato logist 55 km away at the Tampere University Hospital (TAUH). Consultations were performed using standard commercial videoconferencing equipment, a mod ified document camera and a dermatoscope. A single ISDN line (128 kbit/s) w as used for the connection. During the eight months of the study, 25 patien ts participated in a teledermatology consultation. Their mean age was 45 ye ars (range 4-92). The average time the patient spent in travelling to the v ideoconsultation (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 teleco nsultation, 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 T AUH. The equipment was generally reliable and easy to use. However, the der matoscope was not very useful and only one of the consultations relied main ly 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 c onsultations in the TAUH would have been FM18,034. The main economic benefi ts of the videoconferencing were attributable to the reduced travelling and hospital costs. The economic benefits of medical education were more diffi cult to quantify.