Telediagnosis of oral lesions in primary care: the EstomatoNet Program

Abstract

Objective

The diagnosis of oral lesions are often challenging for primary health care 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 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 primary health care by bridging the gap between primary and specialized healthcare.

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