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Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis

British Medical Journal,  May 6, 2000  by R Wootton,  S E Bloomer,  R Corbett,  D J Eedy,  N Hicks,  H E Lotery,  C Mathews,  J Paisley,  K Steele,  M A Loane

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Benefits

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As a result of the learning benefits and increased confidence in managing patients obtained from the joint videolink consultations, general practitioners estimated that dermatology referrals could be reduced by an average of 20% (range 10-25%) with concurrent savings of consultant time, patient time, and patient travel costs. Interview data from one of the health centres was not included in the analysis as a locum was employed to cover the teledermatology sessions and the benefits for a locum may differ from those for a practice member. The general practitioners estimated that it would require an average of 6.3 days of training (range 4.0-7.5) to gain the same experience obtained from being present at the teledermatology consultations. With the average cost of a general practitioner training course at 60.00 [pounds sterling] per day (Northern Ireland Postgraduate Council) and the cost of a general practitioner at 114.00 [pounds sterling] an hour, the cost of equivalent training would be 6123.60 [pounds sterling] per general practitioner. Table 5 shows the total calculated costs and benefits pertaining to the trial. The net cost (to society) of the initial teledermatology consultation was 132.10 [pounds sterling] (SD 24.63 [pounds sterling]) a patient compared with 48.73 [pounds sterling] (18.4 [pounds sterling]) a patient for the initial conventional outpatient consultation.

Table 5 Costs and benefits of telemedicine and conventional consultations (observed data)