Teledermatology in the Waikato region of New Zealand.
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Date
2001-12-18
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Abstract
Teledermatology consultations over a video link began at Health Waikato in 1995 Clinical trials involving about 500 patients have demonstrated the diagnostic accuracy and economic gains of these teleconsultations and patient satisfaction with them Yet six years on out of date equipment remains under used There has been no expansion of the network and no additional clinical teleconsultation services Possible reasons include the excessive capital cost of videoconferencing equipment clinician overwork inconvenience lack of reimbursement administrative and governmental inertia and little demand from patients and their doctors To widen our referral base without the inconvenience of videoconferencing we decided to offer a secure browser based dermatology tele advice service to referring general practitioners who owned digital cameras With the increase in online health information and electronic communication we assumed it would be popular But despite up to six month waits for patients to be seen in the dermatology outpatient clinic few patients have been referred to the service Explanations have included time constraints unavailability of a camera no Internet access at the time of consultation and lack of reimbursement Can we look forward to a future in which all doctors have high speed access to the Internet at their desktop through their practice management systems Who will pay Will they continue to prefer conventional referral