Implementing primary care based Teledermatology in Kent, UK

Background: Teledermatology has been performed in West Kent since 2001. We commenced a primary care based teledermatology service in February 2010 involving a consortia of local GP surgeries using the KSYOS system. The initial pilot phase involved five large group surgeries. Subsequently this has been rolled out to a further 13 practices within the Maidstone area of Kent. The primary care business case estimated that if 70% of referrals (700/year from 18 practices) were directed through teledermatology there could be an anticipated saving of £143,498 (approx. 158,000$) which equates to 62% of current costs to secondary care. Methodology: Two GPs from each practice were trained in the use of the KSYOS system including the taking of good quality digital images. Pigmented lesions and urgent cancer referrals were excluded. Between 17 February 10 and 17 September 10 there were 70 teleconsultations. In 83% of cases the GP would have referred to secondary care hospital clinic but this was subsequently prevented in 88%. Results: The two reporting dermatologists picked up the referral by email and logged into the KSYOS server to report the case. The average response time was 10 working hours. GP feedback showed that the referring doctor felt that they had learnt a lot in 66%, and found the reply helpful in 87% of cases. The service has caused much interest among commissioners who hope to extend the use of teledermatology to other areas of North West Kent (population 1 million) in order to improve waiting times, access to specialist opinion and costs.