Evaluation of skin cancer in Northern California Kaiser Permanente's store-and-forward teledermatology referral program.
OBJECTIVE
To determine whether teledermatology referrals yield a shorter time to biopsy of the most common types of skin cancer versus conventional dermatology referrals.


METHODS
A retrospective chart review was performed of California's Central Valley Kaiser Permanente conventional dermatology or teledermatology referrals that yielded a positive skin cancer biopsy over a 7-month period. Four primary care clinics at Kaiser Permanente's Stockton Medical Center in California's Central Valley were included. Patients who were studied were treated for squamous cell carcinoma of skin, basal cell carcinoma of skin, and malignant melanoma. We compared the time interval between initial evaluation and biopsy of the most common types of skin cancer for teledermatology versus traditional referrals from primary care.


RESULTS
Our study criteria were met by 293 patient cases (58% conventional referrals and 42% teledermatology referrals). The mean time to biopsy of skin cancer was 13.8 days for conventional referrals (median, 12.0 days) versus a mean of 9.7 days (median, 9.0 days) for teledermatology referrals (p<0.0001).


CONCLUSIONS
The use of teledermatology in remote areas results in a shorter time to biopsy than traditional referral methods as a result of improved triaging measures.
1 Department of Dermatology, Emory University School of Medicine , Atlanta, Georgia .
Estelle
E
Kahn
Sarah
S
Sossong
Anne
A
Goh
Diane
D
Carpenter
Sanford
S
Goldstein
D000368:Aged; D002140:California; D003880:Dermatology; D005260:Female; D006801:Humans; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D012017:Referral and Consultation; D012189:Retrospective Studies; D012424:Rural Population; D012878:Skin Neoplasms / Q000175:diagnosis*; D017216:Telemedicine; D013997:Time Factors