Teleconsultation Actions in Reducing In-Person Referrals for Oral Lesions: A Scoping Review.

Abstract

Objectives: This scoping review aimed to investigate the impact of teleconsultation actions on the reduction of unnecessary referrals for specialized in-person care of oral lesions.

Materials and methods: This review included studies on teleconsultation in oral medicine and oral pathology that presented data on the referral flow for in-person care. Teleconsultation modalities included synchronous, asynchronous, or unspecified interactions. Excluded from the review were: (1) reviews, clinical cases, letters, chapters, conference abstracts, and editorials; (2) studies on direct teleconsultation between professionals; (3) telemanagement interventions; and (4) tele-education initiatives.

Results: Nine articles met the inclusion criteria. The asynchronous teleconsultation stands out as the most effective intervention for reducing in-person referrals, observed in eight studies. Referral reductions ranged from 37.3% to 80%, with five studies exceeding 50%. Primary healthcare dentists were the most frequent users of the teleconsultation platform. The most commonly identified lesions found were oral potentially malignant disorders and soft tissue tumors.

Conclusion: Asynchronous teleconsultation may reduce referrals for in-person care, though evidence is limited. Notably, referral rates exhibited significant heterogeneity across studies. Low reduction rates may be attributed to the high proportion of cases requiring in-person assessment. Future research should focus on optimizing referral reduction while addressing the heterogeneity of outcomes.