Store‐and‐Forward Tele‐Dermatology Pilot Study in Belgium: Patients and Physicians Satisfaction Study With Process Evaluation

Background. The use of telemedicine in dermatology is becoming more popular in Belgium and other countries as a result of increasing waiting lists. The objective of this study was to analyze if tele‐dermatology is a valuable alternative for in‐person consultations with the dermatologist and to get insight into the content of the remote consultations, the use, the barriers, and the satisfaction with this system. Methods. This study was a 1‐year prospective pilot study in Belgium. The study implemented and evaluated a store‐and‐forward tele‐dermatology system in the routine practice of Belgian family physicians and dermatologists. Results. A total of 320 family physicians and 43 dermatologists participated in the study. Analysis of remote consultations revealed a median response time of 24 h; 21% of patients needed an additional in‐person consultation after the remote consultation. The majority of dermatologists (67.9%), family physicians (86.6%), and patients (81.4%) were generally satisfied with the service. A majority of the dermatologists agreed that there was sufficient clinical information in the electronic form (60.7%) and that the quality of the pictures was sufficient to allow correct decision making (57.1%). The family physicians had significantly higher percentages respectively, 84.5% and 71.8%. Dermatologists reported technical (73.9%) and organizational (43.5%) problems, whereas these percentages were statistically lower, respectively, 35.2% and 28.2% for the family physicians. Conclusions. The store‐and‐forward tele‐dermatology system had the potential to allow a smooth transfer of high‐quality dermatologic advice. Although there were differences between the dermatologists, the family physicians and the patients, general satisfaction with the system was high. There is a need for an extramural order management system in which the dermatologist could answer from his own electronic medical records.