Photo diagnosis can cut waiting times for dermatology
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《英国医生杂志》
Dermatology waiting times could be substantially reduced if GPs took instant photographs of their patients?visible symptoms and included them in referral letters.
When GPs were given cameras to take instant pictures of skin conditions, the number of patients needing to see a dermatologist was cut by 25%, a report in Family Practice says (2004:21:54-6).
And for more than 60% of patients who had a "photo diagnosis," a management plan was made without the patient needing an appointment with a specialist before diagnosis. The mean time for drawing up a management plan for patients who had a photo diagnosis without an appointment was 17 days, compared with 55 days for those needing an appointment and those in a control group.
"This study shows that referrals which include instant photographs taken by a GP allow a dermatologist to advise appropriate management in more than 60% of cases without seeing the patient face-to-face," say the authors, from the departments of general practice, and epidemiology and public health at Queen抯 University and the department of dermatology, Royal Victoria Hospital, Belfast.
The authors say that about 15% of all GP consultations in the United Kingdom are for dermatological conditions and that 4% of these need secondary referral. They say that studies have shown that while "real time" teledermatology using a video link is a feasible alternative to an outpatient appointment, it is not cost effective or readily available.
In the study, GPs were equipped with Polaroid cameras and given 15 minutes?training in their use. Patients referred by GPs were randomly allocated to study and control groups. Instant photographs were included in the referral letters, and the controls were given outpatient appointments in the usual way.
If diagnosis was not possible from the photographs, patients were given an appointment. If diagnosis was possible, a letter was sent to the GP with advice on management.
For 63% (45/71) of the study group, a diagnosis and a management plan were made without the patient needing an appointment. That included 38% (27/71) who, after diagnosis and initial management, needed an appointment and 25% (18/71) who did not. The rest of the study group (37%; 26/71) required a face to face consultation.
"Instant photography is helpful in managing dermatology referrals and offers the potential to reduce numbers requiring an out-patient appointment by 25%," the authors wrote. "A further 38% may have been saved at least one outpatient attendance as initial management was advised without a consultation.
"We suggest that instant photography offers a straightforward alternative for GPs who have not embraced digital technology. The inclusion of instant photographs with dermatology referral letters offers a potential reduction in the numbers of patients needing out-patient appointments."(Abergavenny Roger Dobson)
When GPs were given cameras to take instant pictures of skin conditions, the number of patients needing to see a dermatologist was cut by 25%, a report in Family Practice says (2004:21:54-6).
And for more than 60% of patients who had a "photo diagnosis," a management plan was made without the patient needing an appointment with a specialist before diagnosis. The mean time for drawing up a management plan for patients who had a photo diagnosis without an appointment was 17 days, compared with 55 days for those needing an appointment and those in a control group.
"This study shows that referrals which include instant photographs taken by a GP allow a dermatologist to advise appropriate management in more than 60% of cases without seeing the patient face-to-face," say the authors, from the departments of general practice, and epidemiology and public health at Queen抯 University and the department of dermatology, Royal Victoria Hospital, Belfast.
The authors say that about 15% of all GP consultations in the United Kingdom are for dermatological conditions and that 4% of these need secondary referral. They say that studies have shown that while "real time" teledermatology using a video link is a feasible alternative to an outpatient appointment, it is not cost effective or readily available.
In the study, GPs were equipped with Polaroid cameras and given 15 minutes?training in their use. Patients referred by GPs were randomly allocated to study and control groups. Instant photographs were included in the referral letters, and the controls were given outpatient appointments in the usual way.
If diagnosis was not possible from the photographs, patients were given an appointment. If diagnosis was possible, a letter was sent to the GP with advice on management.
For 63% (45/71) of the study group, a diagnosis and a management plan were made without the patient needing an appointment. That included 38% (27/71) who, after diagnosis and initial management, needed an appointment and 25% (18/71) who did not. The rest of the study group (37%; 26/71) required a face to face consultation.
"Instant photography is helpful in managing dermatology referrals and offers the potential to reduce numbers requiring an out-patient appointment by 25%," the authors wrote. "A further 38% may have been saved at least one outpatient attendance as initial management was advised without a consultation.
"We suggest that instant photography offers a straightforward alternative for GPs who have not embraced digital technology. The inclusion of instant photographs with dermatology referral letters offers a potential reduction in the numbers of patients needing out-patient appointments."(Abergavenny Roger Dobson)