title: Waikato Teledermatology: a pilot project for improving access in New Zealand.
abstract: BACKGROUND
  Teledermatology can improve access to specialist dermatological advice. We describe a retrospective review of the first 12 months of Waikato Teledermatology (WT), a low-cost, secure, website-based, store-and-forward teledermatology network using the Collegium Telemedicus platform.
  
  
  METHODS
  We determined specialist response time, referral metrics, patient diagnosis and progress reports from the network's database. The programme's value was evaluated by post-pilot online surveys of referrers and specialist dermatologists.
  
  
  RESULTS
  WT was used by 31 referring doctors for 309 consultations with four dermatologists between July 2013 and June 2014. Mean and median specialist response time was 2.07 hours (range: 0.13-5.64 hours). The researchers categorized the referrals as tumours (56.8%) and rashes (43.2%), including inflammatory dermatoses (51.9%), infection (18.1%), uncertain (16.5%), miscellaneous (7.5%), and of environmental origin (6%). Thirty tumours were biopsied, including nine melanomas and three basal cell carcinomas. A total of 158 progress reports and 35 survey responses were received. Reported advantages included decreased delay, improved accuracy of diagnosis and treatment compared to that made without specialist input, decreased unnecessary procedures such as biopsies of undiagnosed conditions, and increased appropriate referrals for face-to-face assessment, thus leading to cost savings for the patient and the health care system. The major disadvantages were the time burden for clinicians to complete consultations, the lack of integration with the patients' usual electronic medical record and absence of funding.
  
  
  CONCLUSIONS
  WT proved an effective and acceptable approach to improving patient access to dermatologic services.
authors.affiliation: Department of Dermatology, Wayne State University - School of Medicine, MI, USA.
authors.forename: Suzanne T
authors.initials: ST
authors.lastname: McGoey
authors.affiliation: Waikato Clinical Campus, University of Auckland, New Zealand Department of Dermatology, Waikato Hospital, New Zealand Amanda.oakley@waikatodhb.health.nz.
authors.forename: Amanda
authors.initials: A
authors.lastname: Oakley
authors.affiliation: Waikato Clinical Campus, University of Auckland, New Zealand Department of Dermatology, Waikato Hospital, New Zealand.
authors.forename: Marius
authors.initials: M
authors.lastname: Rademaker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D003880:Dermatology / Q000458:organization & administration*; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D010865:Pilot Projects; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012871:Skin Diseases / Q000175:diagnosis / Q000628:therapy; D017216:Telemedicine / Q000379:methods*; D014850:Waiting Lists; D055815:Young Adult
keywords: Teledermatology; telehealth; telemedicine