Telediagnosis of oral lesions in primary care: The EstomatoNet Program

Objective The diagnosis of oral lesions is often challenging for primary healthcare providers, which explains the high number of referrals to specialist care. This favors increases in waiting lines and delays in diagnosis, contributing to high mortality rates from oral cancer. This study aimed to su...

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Bibliographic Details
Published in:	Oral diseases Vol. 24; no. 6; pp. 1012 - 1019
Main Authors:	Carrard, VC, Roxo Gonçalves, M, Rodriguez Strey, J, Pilz, C, Martins, MAT, Martins, MD, Schmitz, CA, Dal Moro, RG, D'Ávila, OP, Rados, DRV, Harzheim, E, Gonçalves, MR
Format:	Journal Article
Language:	English
Published:	Denmark Wiley Subscription Services, Inc 01-09-2018
Subjects:	access to care Adult Aged Attitude of Health Personnel Biopsy Brazil community dentistry Cross-Sectional Studies decision‐making Dentistry Dentistry - methods Dentists Diagnosis Female health services research Humans Hyperplasia Inflammation Male Middle Aged Motivation Mouth Diseases - diagnostic imaging Oral cancer oral diagnosis Photography practice management Primary care Primary Health Care - methods Referral and Consultation - statistics & numerical data Squamous cell carcinoma Telemedicine Young Adult Brazil health services research practice management community dentistry oral diagnosis access to care decision-making
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Summary:	Objective The diagnosis of oral lesions is often challenging for primary healthcare providers, which explains the high number of referrals to specialist care. This favors increases in waiting lines and delays in diagnosis, contributing to high mortality rates from oral cancer. This study aimed to summarize the experience of the EstomatoNet, a telediagnosis program catering to primary care dentists and physicians from southern Brazil. Study design This exploratory study included all queries received by EstomatoNet from June 2015 to December 2016. Health providers (71 dentists and 18 physicians from primary care) submitted requests including clinical information and photographs of oral lesions by means of a cloud‐based platform. Specialized oral medicine teleconsultants received the data, conveyed a diagnostic hypothesis, and conveyed management recommendations. Results Actinic cheilitis (n = 41, 15.8%), squamous cell carcinoma (n = 22, 8.5%), and inflammatory hyperplasia (21, 8.1%) were the most frequent diagnoses. Teleconsultants recommended referral to specialists in 42.9% of the cases, total biopsy in 23.6%, and follow‐up in 16.2%. After the EstomatoNet use, the intention to refer the patients to face‐to‐face consultation reduced from 96.9% to 35.1%. Conclusion Telediagnosis for oral lesions is feasible and has potential to improve the quality of primary health care by bridging the gap between primary and specialized health care.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1354-523X 1601-0825
DOI:	10.1111/odi.12851