e-Health/m-Health services for dermatology outpatients screening for skin cancer and follow-up

Le résumé fourni par la source

Skin cancers and melanoma represent one of the most common cancer types, and their incidence is growing in last decades, especially, among Caucasians and in places with strong ultraviolet insolation. Early stage diagnosis significantly improves patients' survival rates. We aimed to evaluate the efficiency of m-Health and e-Health methodologies (e-registry, mobile teleconsultations and teledermoscopy) among dermatological outpatients with different pigmented lesions for skin cancer screening and follow-up. 584 outpatients from Tbilisi (301 pts) and seaside rural region - Adjara (283 pts) have been engaged in TeleDerm project. Total 2811 teledermoscopic investigations (5.1 per patient) have been carried out. In 91.9% benign and in 8.1% malignant pathologies were mostly correctly diagnosed by teledermoscopic investigation. As a result of teleconsultations of remote patients initial clinical diagnosis was confirmed by teledermoscopy in 65.6% and modified/corrected - in 34.4%. Problems of mobile communication - delay/stacking of transferring large dermoscopic images - were registered in 9% of the cases. Cost of teledermatology consultation was 3.7-55 times lower than in a traditional settings. According to Quality of Experience surveys, 62.5%-86.5% of patients and 70%-90% of physicians ranked TeleDerm service as beneficial, cost- and time-efficient, and improving their confidence in qualified medical care provision. Teledermatology with teledermoscopy could be regarded as a method of choice for skin cancer screening, dermatology patients' full-scale e-registry development and follow-up in case of onco-vigilance. m-Teledermoscopy represents feasible and cost-efficient methodology, particularly - for regional healthcare institutions with limited specialized diagnostic tools.

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