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Part 1 of this article reviewed a case study regarding a UK-based clinic which implemented teledermoscopy services for streamlined care. Although staff reported that “patients received care far more quickly”, the practice was running at a slight loss in spite It is interesting to note that physicians reported using the services to practice their dermatology skills by including a “guess” diagnosis when referring to a dermatologist. The following article will analyze another implemented case of teledermoscopy services for expedited referrals, this time in Australia.
The goal of this study was to assess the cost-effectiveness of teledermoscopy for the referral of skin cancer diagnoses in Australia, as no previous literature had been recorded in this area. These services (utilizing an electronic referral system containing dermoscopic images) were compared to traditional referral methods (such as a written letter of referral) in terms of costs and the time experienced for patients to receive a final diagnosis. 1
Inverse to Case 1, practices in this study charged patients a greater amount for teledermoscopy services in comparison to traditional in-office visits. However, this resulted in reports of a very slim profits rather than loss:
Services cost an additional ~A$54.64 per person
Cost savings per day was an average of $2.10
Mean clinical resolution was 9 days compared to 35 days with usual care
In spite of many teledermoscopy-supported practices reporting the lowered cost of care for patients, this study noted that services cost each patient an average additional $55 per visit. However, in spite of such a drastic increase this only warranted the daily cost savings of $2, suggesting that teledermoscopy services in this scenario simply shift the burden of cost to the patient, which may prove unattractive to low-income demographics.
The study concludes that “Implementation recommendations depend on the preferences of the Australian health system decision makers for either lower cost or expedited clinical resolution”, suggesting that each practice’s unique structure and patient types will be heavily dependent of the value of adopting the services.
In both cases the primary conclusion was that teledermoscopy services drastically reduce patient wait times, it was generally inconclusive if the methods were an attainable source of revenue (or could simply break virtually given the correct circumstances). However, this fails to account for the greater impact that streamlined patient care will have on the health industry. Economic benefits could result from fewer face-to-face specialist referrals, reduced travel times, wait times, the earlier detection of skin cancer or other conditions and the faster, cheaper treatment of these diseases.
Using the early detection of skin cancer as only one example, reports suggest that along with a greater survival rate (98%), its treatment costs an average of $1,700 USD to treat stage 1. In contrast, it costs an average of $56,000 USD to treat Stage IV and survival rates drop to only 16%.2 Building on these statistics alone, it is incorrect to assume that teledermoscopy services fail to provide an additional source of revenue; rather the method works to relieve the cost of burden through virtually every step of the industry through its ability to expedite care. Although further research is needed, it is reasonable to conclude that teledermoscopy services offer a viable solution for the early detection of melanoma and other serious dermatology conditions through expediting care, resulting in the opportunity for lowered costs not only within the practice, but the greater healthcare system and for the patient themselves.
-The MetaOptima Team
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