Previously submitted to: JMIR Dermatology (no longer under consideration since Sep 06, 2022)
Date Submitted: Apr 7, 2022
Open Peer Review Period: Apr 7, 2022 - Jun 2, 2022
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Teledermatology in Chile: Implementation of a single national system.
ABSTRACT
SUMMARY: Introduction: Teledermatology(TD) allows the delivery of timely and quality care. Although the implementation of local systems has shown to provide good levels of resolvability, the implementation of a single system at the national level allows to reach all geographical areas in a uniform and timely manner.
Objective:
To describe the results of the implementation of a unified national TD system in Chile.
Methods:
Observational-retrospective study of electronic interconsultations (EIs) resolved by TD specialty in national teledermatology system from December 1st, 2018, to December 31st, 2020.
Results:
A total of 49,211 electronic interconsultations from all geographic areas of Chile. From these, 57.55% received a diagnosis and treatment that could be delivered in a Primary Health Care (PHC), thus, preventing the inadequate referral of 28,321 patients to the secondary level. The most frequent specific diagnoses were: melanocytic nevus 8.86% (n:4364), Non-melanoma skin cancer 8.73%(n:4294) and irritant contact dermatitis 8.2%(n:4037).From the sample, female sex accounted for 29,942(60.8%) of the consultations. Age and latency in the resolution of median EI/interquartile range were 43/24 years and 3.5/6.4 days respectively. Finally, the diagnostic agreement between the TD specialist and the PHC physician was 71.03%. Conclusion: The implementation of a single national TD system, which incorporates a high volume of IE and all the geographical areas of Chile, has shown to have high levels of resolvability, low waiting times, and a high level of resolution centers of origin. This could be an alternative to optimize healthcare attention in the public system of low to middle-income countries.
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