55 ELEVEN YEARS OF TELEDERMOSCOPY IN THE NETHERLANDS Table 3.1: Quality and performance outcomes with their description and used evaluation questions. Quality outcomes Description Evaluation questions 1. Second opinion The percentage of teledermoscopy consultations initiated by GPs to request teledermatologists’ advice for patients that would (without availability of teledermoscopy) not have been referred by the GP to dermatologic care. Q1 = No 2. Extra teledermoscopy referrals The percentage of patients referred to the dermatologist of which the GP indicated that he would not have physically referred these patients without teledermoscopy. Q1 = No AND Q3 = Yes 3. GP following teledermatologist’s advice on patient referral Agreement percentage between the GP and teledermatologist on patient referral after the teledermoscopy consultation. The numerator is the total number of consultations for which Q2 and Q3 had the same response. The denominator is the total number of consultations with Yes or No as a response to Q2. (Q2 = Q3) / (Q2 = Yes OR Q2 = No) 4. GP valuation of teledermoscopy The percentage of consultations for which the GP indicated to have been helped/supported. Q4 = Yes, Some The percentage of consultations for which the GP indicated to have gained (dermatologic) knowledge. Q5 = Yes, Some Performance outcomes Description Evaluation questions 5. Teledermoscopy referral of patients otherwise referred The percentage of patients who would have been referred to the dermatologist if teledermoscopy would not have been available, but who are not referred after a teledermoscopy consultation as reported by the GP. Q1 = Yes AND Q3 = No 6. Overall referral in teledermoscopy The numerator is the total number of patients when Q3 is answered with “Yes”. And the denominator includes the total number of patients when Q1 is answered with “Yes”. ((Q3 = Yes) / (Q1 = Yes))*100% 7. Time needed of GPs to create and send a teledermoscopy consultation, and teledermatologists’ answering and response time (time between sending and receiving answer) The time (minutes, seconds) needed by GPs to create and send a teledermoscopy consultation (median, IQR), and teledermatologists’ answering (median, IQR) and response time (median, mean, IQR). Timestamps were retrieved from the teleconsultation system (after July 2011). GP: general practitioner. 3
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