A prospective study in the Netherlands investigated the effect of teledermatology on the efficiency, quality and costs of care when used in daily practice and applied following general practitioner (GP) selection. From March 2007 to September 2010, 37,207 teleconsultations between 1,820 GPs and 166 dermatologists were performed. When teleconsultations (n = 26,956) were used to prevent a referral, 74% of physical referrals were prevented. When used for a second opinion (n = 10,611), 16% were physically referred. The prevented referral rate in the total population was 68%, with a median response time of 2 hours by the dermatologists. A beneficial educational effect was reported by 85% of the GPs and an ...