20th Wonca Europe Conference 2015. Wonca 2015 Istanbul. New Ways for Dealing with Medical Conditions. It has been known for the last 2 decades that telemedicine provides better access to users in addition to reducing the waiting time between diagnosis in primary care and hospital. In the Catalonian central region, two counties, Bages and Berguedà, have developed a teledermatology programme, which have had considerable success in reducing waiting lists while having wide acceptance among patients. This service is especially useful in rural areas where has been able to attend thousands avoiding unnecessary trips. I would like to share my experience first as a manager implementing the teledermatology programme in 2010 and now working as a rural GP and actively using this service in my day-to-day work.

1. Using teledermatology effectively
in rural Primary Care settings
Dr Josep Vidal-Alaball. Primary Care Physician. MPH
BRITES: New Ways for Dealing with Medical Conditions

2. Provides better access to users
Van Der Heijden, J.P. et al., 2011. Teledermatology applied following patient selection by general practitioners in daily
practice improves efficiency and quality of care at lower cost. British Journal of Dermatology, 165(Table 1), pp.1058–
1065
Is both effective and efficient
Hersh, W.R. et al., 2002. A systematic review of the efficacy of telemedicine for making diagnostic and
management decisions. Journal of Telemedicine and Telecare, 8(4), pp.197–209
Ekeland, A.G., Bowes, A. & Flottorp, S., 2010. Effectiveness of telemedicine: a systematic review of reviews.
International journal of medical informatics, 79(11), pp.736–71
Enjoy a high acceptance among users
Devine, J., 2009. User satisfaction and experience with antelemedicine service for diabetic footndisease in an
Australian rural community. Available at:
http://www.ircst.health.nsw.gov.au/__data/assets/pdf_file/0009/98397/Jenni_Devine_report.pdf.
Telemedicine …

3. In the Catalonian Central Region, dermatology waiting
lists had increased significantly during the years 2010-2011
To try to reverse this trend in early 2011 we began a
teledermatology project
Since the start of the project, the median (confidence
interval 95%) of the days on the waiting list has reduced
from 30 (29; 32) to 16 (15; 17) days *
*Vidal-Alaball, J. et al., 2014. Evaluación del impacto de la teledermatología en la
disminución de la lista de espera en la comarca del Bages (2009-2012). Aten Primaria,
pp.9–10.
Reduces waiting lists

4. Teledermatology Pathway
HC
1. We take a picture of the lesion (Digital Camera - iPad)
2. We include the picture in the e-clinical history
3. We write the clinical history for the Dermatologist
in the e-notes
4. The dermatologist has access to the e-history
5. The dermatologist looks at the pictures, writes a
diagnosis and suggest treatment or ask for a
referral

5. Josep Vidal-Alaball
josep.vidal@gmail.com
Twitter: @jvalaball http://www.slideshare.net/jvalaball