Teledermatology triage results in cost savings

Implementation of a teledermatology (TD) triage system appears to reduce costs in a managed healthcare setting, according to findings published in JAMA Dermatology (Nov. 18, 2020).

In the paper, researchers note that prior studies have shown that TD triage can improve patient access to care, but the impact on costs has been unclear.

To study the costs of managing newly-referred dermatology patients at a single centre, the investigators conducted a retrospective cost minimization analysis involving 2,098 patients (1,154 men, 1,099 women) referred to the dermatology department at the Zuckerberg San Francisco General Hospital and Trauma Center (ZSFG) between June 1 and Dec. 31, 2017.

Costs were estimated using decision-tree models to characterize possible care paths with TD triage and within a conventional dermatology care model. The research team applied costs associated with primary care visits, dermatology visits, and TD visits to the decision-tree models to estimate the mean cost of managing patients following each care path for six months. The mean cost for each visit type incorporated personnel costs, with the mean cost per TD consultation also incorporating software implementation and maintenance costs. Patient data were then applied within the models in order to determine the probability of the different care paths and to calculate the mean cost per patient within each model.

Within the decision-tree model of TD triage, the mean cost per patient to the healthcare organization was US$559.84. In the model for conventional dermatology care, the mean cost per patient was US$699.96. This was a statistically significant difference of US$140.12 per patient.

The authors note that with an annual dermatology referral volume of 3,150 patients at this institution, this difference represents an estimated annual savings of US$441,378.

“This study suggests that using teledermatology to triage and manage dermatology patients within a capitated healthcare system may be associated with significant cost savings,” the authors write.