A Multisite Service Evaluation of Paediatric Teleconsultations

Abstract Paediatric dermatology teleconsultations have become familiar territory since the Covid-19 pandemic. There is a continued drive to provide teleconsultations, with efficiency and cost-saving cited as benefits. Yet, this is not supported by a recent UK-wide survey of health professionals.1 We evaluated practice across two paediatric dermatology centres, to assess time required for teleconsultations. Data were collected prospectively from paediatric dermatology outpatient consultations for patients <16 years over 2 weeks in March and 4 weeks in September 2022. Consultation type (face-to-face/telephone/video), patient demographics, diagnosis and consultation length were reviewed. Caldicott approval was obtained. A total of 173 consultations were included. There was a range of diagnoses including eczema (n=60), skin lesions (n=22), vascular lesions (n=28) and other inflammatory skin conditions (n=63). Most consultations were face-to-face (n=108, 62%), while 38% (n=65) were teleconsultations. Median consultation duration was 13 minutes, 45 seconds (range: 2.5min–1hour 5min 2s). Comparison of consultation duration across 3 modalities (face-to-face vs telephone vs video) demonstrated no statistical significance between groups. (H(2)=5.76, P=0.056). There was a trend toward significance, likely due to 3 face-to-face consultations with duration of >50 minutes. Limitations include relatively small sample size and consultations carried out by few clinicians. Consultation modality is often influenced by case complexity, i.e., more complex consultations are likely to be held face-to-face. Future work includes a health-economic analysis of teleconsultations to determine if these are cost-effective.