Dermatology appointments often involve long wait times, which can delay diagnosis and negatively impact patient outcomes. In regions facing a shortage of dermatologists, telemedicine—specifically tele-expertise—is emerging as an effective solution to improve access to care.

Tele-expertise: A New Model of Care Coordination

According to Dr. Henry Pawin, video-based teleconsultation is not ideal for dermatology. The image quality is often insufficient, and certain body areas are difficult to show via webcam.

Tele-expertise, on the other hand, facilitates collaboration between a referring physician and a dermatology expert. The general practitioner remains the patient’s primary point of contact, but receives a specialist’s opinion without delay. This model reassures the patient and ensures fast, effective care.

Since April 1st, 2022, Avenant 9 of the French Medical Convention introduced a tiered reimbursement model:

• The referring physician receives €10 per request (code RQD)
• The expert dermatologist receives €20 per response (code TE2)

How Does Tele-expertise Work?

After obtaining the patient's consent, the general practitioner takes photos of the skin condition using a smartphone and fills out a brief form. This data is securely submitted through a dedicated platform to a dermatology expert.

The expert reviews the case, provides a diagnosis, and suggests next steps—whether that involves treatment, a biopsy, or an in-person consultation.

The Burgundy Pilot: A Proven Success

In Burgundy, physicians have been using tele-expertise for skin tumors for several years, with support from the regional health agency (ARS). In 2021, they conducted 1,225 tele-expertise cases, yielding promising results:

• 37% of cases led to surgery
• 70% were cancerous tumors, including 4 melanomas
• Only 40% of patients required a follow-up in-person consultation

This system improves access to care while reducing unnecessary appointments, freeing up capacity for urgent cases.