Evaluation of general practitioner's time investment during a store-and-forward teledermatology consultation

Background/objective: Introduction of teledermatology in general practice changes responsibilities and workloads of general practitioners (GPs) and dermatologists. We investigated the time investment of GPs as well as the relative share of the separate teledermatology activities during a store-and-forward teledermatology consultation. Methods: Sixty-four teledermatology consultations (eight GPs x eight patients) were conducted in a laboratory setting. The starting and ending time of each consultation and of five separate teledermatology activities were recorded by independent observers. The impact of several GP, patient and consultation characteristics on the calculated durations was investigated with repeated measurements analysis. Results: The mean duration of a teledermatology consultation was 11:32 min (range 7:02-26:44 min). The activity 'filling out electronic referral form' was the most time consuming teledermatology activity (3:12 min; 28%). Most time was spent on non-TD related consultation activities, e. g. taking medical history (4:43 min; 41%). The first of the eight consultations (p < 0.001) and consultations with female patients (p = 0.032) took on average more time than subsequent consultations (first consultations 13:42 min (male patients) and 17:03 min (female patients), and subsequent consultations 9:56 min (male patients) and 11:08 min (female patients)). Conclusions: Usage of store-and-forward teledermatology increases the average duration of a GP consultation with at least three and a half minutes. Further integration of teledermatology applications and electronic patients' records may reduce the total duration of a consultation and increase acceptance of teledermatology in general practice. (C) 2007 Elsevier Ireland Ltd. All rights reserved.