Clinical Course Outcomes for Store and Forward Teledermatology Versus Conventional Consultation: A Randomized Trial

Whited, John D.; Warshaw, Erin M.; Kapur, Kush; Edison, Karen E.; Thottapurathu, Lizy; Raju, Srihari; Cook, Bethany; Engasser, Holly; Pullen, Samantha; Möritz, Thomas; Datta, Santanu K.; Marty, Lucinda; Foman, Neal; Suwattee, Pitiporn; Ward, Dana S.; Reda, Domenic J.

doi:10.1177/1357633x13487116

Cited by 44 publications

(32 citation statements)

References 15 publications

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“…6,7 In brief, consenting participants who were referred from 1 of the sites of primary care to 1 of the dermatology services were randomized to a teledermatology referral (teledermatology group) or a conventional referral (conventional referral group). The conventional referral process consisted of the referring clinician generating a text-based consultation to the dermatology service using the VA Computerized Patient Record System.…”

Section: Interventionsmentioning

confidence: 99%

Cost and Utility Analysis of a Store-and-Forward Teledermatology Referral System

et al. 2015

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IMPORTANCEThe costs and utility of teledermatology are important features of implementation. Such an analysis requires a description of the perspective of the entity that will bear the cost.OBJECTIVE To assess the costs and utility of a store-and-forward teledermatology referral process compared with a conventional referral process from the perspectives of the Department of Veterans Affairs (VA) and society. DESIGN, SETTING, AND PARTICIPANTSThree hundred ninety-one randomized participants were referred from remote sites of primary care to the dermatology services of 2 VA medical facilities for ambulatory skin conditions from December 2008 through June 2010, and follow-up was completed in March 2011. The time trade-off utility measures and costs were collected during a 9-month period among participants in a 2-site parallel group randomized clinical trial. The perspectives of the VA and society were evaluated. The multiple imputation procedure or weighted means were used for missing data elements. Data were analyzed from January to July 2014.INTERVENTIONS Referrals were managed using store-and-forward teledermatology or a conventional text-based referral process. MAIN OUTCOMES AND MEASURESTotal costs from the perspectives of the VA and society incurred during the 9-month follow-up were used to derive per-participant costs. Utility, using the time trade-off method, was the measure of effectiveness.

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Section: Interventionsmentioning

confidence: 99%

Cost and Utility Analysis of a Store-and-Forward Teledermatology Referral System

et al. 2015

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“…S&F teledermatology has been shown to have comparable diagnostic accuracy to conventional methods while improving patient access, being cost effective, and even improving remote medical education [3–5]. Furthermore, S&F teledermatology has been shown to not have significant differences in clinical outcomes as compared to traditional referrals [6, 7]. …”

Section: Introductionmentioning

confidence: 99%

Store-and-forward teledermatology: a case report

Lenardis

Solomon²,

Leung³

2014

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BackgroundTelemedicine is increasingly being used as part of routine practice for many physicians and healthcare providers across the country. Due to its visual nature, dermatology is ideally suited to benefit from this new technology. The use of teledermatology (telemedicine in dermatology) in a primary care setting allows for an expert opinion without the need for an in-person referral. Furthermore, it can improve patient access in remote areas. Store-and-forward teledermatology is the most commonly employed method.Case presentationThis case describes a Caucasian male in his fifties with no fixed address or telephone number who presented to his family doctor with an enlarging nevus on his chest, and required a dermatology referral. Given these limitations, a traditional fax and phone referral would not be possible. Instead store-and-forward teledermatology was employed. It was then determined by the dermatologist that the nevus was benign and did not require treatment.ConclusionThis case demonstrates the utility of store-and-forward teledermatology in what is unfortunately not an uncommon scenario in Canada. The patient was successfully managed, and a logistically difficult and expensive in-person referral was avoided.

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“…One study used the intervention for both screening and follow-up. All the others 24,25 used teledermatology for only follow-up.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…14 Eleven studies were randomized controlled trials [11][12][13][14][15][16]18,[20][21][22][23][24][25] (Table S3). One study used the intervention for both screening and follow-up.…”

Section: Clinical Outcomesmentioning

confidence: 99%

“…[11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] All studies were from high income countries. Six studies (seven articles) were from the United States, 11,15,18,21,[23][24][25] two from the Netherlands, 17,22 and one from each of the following countries: Austria, 16 Canada, 20 Denmark, 26 Italy, 12 Norway, 13 Singapore, 19 and United Kingdom.…”

Section: Clinical Outcomesmentioning

confidence: 99%

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