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Store-and-forward teledermatology referrals have comparable, lower costs than conventional referrals

Store-and-forward teledermatology referrals were performed at a comparable cost using a Veterans Affairs perspective, or a lower cost using a society perspective when compared with conventional referrals, according to recently published study results.

Researchers studied 391 participants (mean age, 62.3 years; 97.7% male) at two VA medical facilities, who were referred for ambulatory skin conditions between December 2008 and June 2010. The participants were randomly assigned to a conventional referral group (n=196) or a store-and-forward teledermatology referral group (n=195). Participants were followed through March 2011.

During the follow-up, time trade-off utility measures and costs were collected. VA and society perspectives were evaluated, and data analysis was conducted between January and July 2014.

Store-and-forward teledermatology or conventional text-based referral process were used to manage referrals. Per-participant costs were derived from total costs incurred during the 9-month follow-up based on VA and societal perspectives.

The conventional referral group had 303 dermatologic clinic visits with a mean cost of $45,353, while the teledermatology referral group had 214 dermatology clinic visits with a mean cost of $32,032. There was a mean of $5,120 in referral cost in the teledermatology group.

Mean total cost for conventional referrals was $66,145, or $338 per participant, while the mean total teledermatology referral cost was $59,917 or $308 per participant using the VA perspective. The $30 difference in the per-participant cost was not significant (95% CI, -$79 to $20).

Mean total cost for conventional referrals was $106,194 from societal perspective, or $542 per participant, and the total cost of teledermatology referral was $89,523 or $460 per participant. There was a statistically difference of $82 in per-participant cost (95% CI; -$12 to -$152).

In rating effectiveness, the time trade-off utility value improved by 0.02 in the conventional referral group and 0.03 in the teledermatology group, with no statistically significant difference.

“No evidence suggests a difference in utility, as measured by a time trade-off utility assessment, between randomization groups,” the researchers concluded.  – By Bruce Thiel

Disclosure: Datta reports no relevant financial disclosures. Please see the study for a full list of other researchers’ relevant financial disclosures.