Performance accuracy, advantages and limitations of a store-and-forward teledermatology platform developed for general practitioners: A retrospective study of 298 cases

C Faucon; D Gribi; D S Courvoisier; P Senet; O Itani; A Barbaud; A-M Magnier; C Frances; J Chastang; F Chasset

doi:10.1016/j.annder.2022.01.012

Performance accuracy, advantages and limitations of a store-and-forward teledermatology platform developed for general practitioners: A retrospective study of 298 cases

Ann Dermatol Venereol. 2022 Dec;149(4):245-250. doi: 10.1016/j.annder.2022.01.012. Epub 2022 Jun 17.

Authors

C Faucon¹, D Gribi², D S Courvoisier³, P Senet⁴, O Itani⁵, A Barbaud⁴, A-M Magnier⁶, C Frances⁴, J Chastang⁶, F Chasset⁴

Affiliations

¹ Sorbonne Université, Faculté de Médecine, Assistance publique-Hôpitaux de Paris, Service de dermatologie et allergologie, Hôpital Tenon, 75020 Paris, France. Electronic address: faucon.caro@gmail.com.
² Médecine Générale, Université Paris Est, Faculté de médecine, 94000 Créteil, France.
³ Rheumatology Department, University Hospital and School of Medicine, Geneva, Switzerland.
⁴ Sorbonne Université, Faculté de Médecine, Assistance publique-Hôpitaux de Paris, Service de dermatologie et allergologie, Hôpital Tenon, 75020 Paris, France.
⁵ Assistance publique-Hôpitaux de Paris, Service de maladies infectieuses et tropicales, Hôpitaux universitaires Pitié-Salpêtrière Charles-Foix, 75013 Paris, France.
⁶ Département de médecine générale, Sorbonne Université, 75012 Paris, France.

PMID: 35725669
DOI: 10.1016/j.annder.2022.01.012

Abstract

Background: Store-and-forward (SAF) tele-dermatology (TD) platforms could help promote coordination between hospital and general practitioners (GPs). However, very little data exists on the performance accuracy and opinions of GPs participating in this type of project in France.

Methods: We report on the diagnostic and management plan accuracy of an SAF-TD platform developed for neighbouring GPs around our hospital compared with routine face-to-face (FTF) dermatological consultation in our department. We also compared the accuracy of SAF-TD with that of the participating GPs. Lastly, we collected feedback from GPs after their participation in this project.

Results: Overall, 298 patients were included by 58 GPs between November 2016 and January 2020, of whom 169 (57%) were female, and with a median age of 44.5 years (range 0-96). The diagnostic accuracy of TD was 62% (n=184/298) for the initial hypothesis and 80% (n=239/298) for aggregated diagnostic accuracy. Management plan accuracy for TD was 81% (n=225/277). At least 43% of consultations (n=127/298) met the criteria for preventable consultation. Diagnostic accuracy for the initial hypothesis was significantly lower for GPs than for TD (Odd Ratio [OR]=0.34; 95% Confidence Interval [95% CI]: 0.20-0.56; p<0.0001), as was management plan accuracy (OR=0.23; 95% CI: 0.10-0.46; p<0.0001). Among the responding GPs, 78% (n=29) reported very high satisfaction and 97% would consider integrating this type of programme in their long-term practice, but they highlighted the time-consuming nature of the platform (46%) and the lack of financial compensation (44%).

Conclusion: SAF-TD in coordination with GPs seems safe and efficient in the management of outpatients, and enjoys a high satisfaction rate among GPs, despite its time-consuming nature and the lack of financial compensation. Healthcare policy should promote financial participation to help the expansion of TD.

Keywords: Dermatology; General practitioners; Telemedicine.

MeSH terms

Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Dermatology*
Female
General Practitioners*
Humans
Infant
Infant, Newborn
Male
Middle Aged
Referral and Consultation
Retrospective Studies
Skin Diseases* / diagnosis
Skin Diseases* / therapy
Telemedicine*
Young Adult