Direct patient-to-physician teledermatology: Not a flash in the pan(demic)

Ethical and Legal Challenges of Telemedicine in the Era of the COVID-19 Pandemic

“…The concerns reported by the selected articles mostly pertain to the ethical and legal aspects (often interlinked), which were already highlighted in previous literature before the pandemic [7], but nevertheless remain crucial. These included the following: informed consent (information about the risks and benefits of remote therapy) and autonomy (87%), patient privacy (78%) and confidentiality (57%), data protection and security (74.%), malpractice and professional liability/integrity (70%), equity of access (30%), quality of care (30%), the professional-patient relationship (22%), and the principle of beneficence or being disposed to act for the benefit of others (13%) [1,6,8,10,11,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. Non-maleficence is the principle of preventing harm by actively promoting confidentiality, safety/safeguarding, and security.…”

“…Commentary Italy [1] Law/regulations/legal issues (83%) stress the absence or variation of the rules among countries and the need for guidelines/best practices or standardization of telemedicine services. In particular, the questions raised regarded the following aspects: costs of services and reimbursement, insurance coverage, virtual prescription of medications, accreditation, licensing, commercialization, recording (as an area of controversy), and evaluation of the effectiveness of the services such as health outcomes and delivery, in terms of quality and cost, individual experience, program implementation, and key performance indicators [1,6,8,10,11,16,19,[21][22][23][24][27][28][29][30][31][32]34].…”

Synchronous and asynchronous teledermatology: A narrative review of strengths and limitations

“…Proper image submissions require that patients own adequate devices, take photos with appropriate lighting and focus, and possess health and technological literacy to navigate software and upload photos and relevant medical history. 38 Patients may have difficulty providing images or history of sufficient quality, leading to inadequate submissions that require follow-up and resubmission, increasing work load for clinicians and staff (Table 1). 39,40 Limitations common to both teledermatology formats include the inability to conduct procedures, full physical exams, and administer certain advanced treatments.…”

Digital skin imaging applications, part II: a comprehensive survey of post‐acquisition image utilization features and technology standards

“…2 Dermatology-related smartphone applications ("apps") grew by over 80% from 2014-2017 and COVID 19-related policy changes have catalyzed the widespread practice of teledermatology (TD) services. [3][4][5][6][7] TD is now cited as one of the most common uses of telemedicine and is an active area of clinical investigation. [8][9][10][11] Skin imaging and image utilization are central to the functionality of many dermatology applications.…”

“…The percentage of U.S. adults who own a smartphone more than doubled from 35% in 2011 to 85% in 2021, with nearly three‐quarters also reporting having desktop or laptop computers and access to in‐home broadband service 2 . Dermatology‐related smartphone applications (“apps”) grew by over 80% from 2014–2017 and COVID 19‐related policy changes have catalyzed the widespread practice of teledermatology (TD) services 3–7 . TD is now cited as one of the most common uses of telemedicine and is an active area of clinical investigation 8–11 …”