Store-and-forward teledermatology improves care and reduces dermatology referrals from walk-in clinics: A retrospective descriptive study

McAfee, John L.; Vij, Alok; Warren, Christine

doi:10.1016/j.jaad.2019.08.006

Cited by 20 publications

(20 citation statements)

References 5 publications

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“…In another Brazil's state, Santa Catarina, a SF-TD program has been also in place for 12 years, reducing referrals to in-person dermatologists by 44% [18] . A similar project with 500 patients found 72% of patients with no need for in-person dermatologists [19] . In our project, we had the benefit of directly referring patients for biopsies, which was a new improvement in relation to the previous two studies.…”

Section: Discussionmentioning

confidence: 96%

Teledermatology reduces dermatology referrals and improves access to specialists

2020

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Background: Teledermatology may be used for triage in primary care to address skin conditions, improving access and reducing time to treat the most severe or surgical cases. We aimed to evaluate the proportion of individuals who could be assessed in primary care using teledermatology, and how this affected the waiting time for an in-person dermatologist appointment. Methods: A cross-sectional retrospective study, involving 30,976 individuals and 55,624 skin lesions, was performed from July 2017 to July 2018 We assessed the frequency of diagnoses and referrals to biopsy, to in-person dermatologists, or to primary care, and compared the waiting time for an in-person dermatologist appointment before and after the teledermatology implementation. Findings: 53% of the patients were managed with the primary care physician, 43% were referred to in-person dermatologists and 4% directly to biopsy, leading to a reduction of 78% in the waiting time for in-person appointments when compared to the previous period. The most frequent diseases were: melanocytic nevus, seborrheic keratosis, acne, benign neoplasms, onychomycosis, atopic dermatitis, solar lentigo, melasma, xerosis, and epidermoid cyst, with significant differences according to sex, age and referrals. The most frequent treatment prescribed was emollient. Interpretation: The use of teledermatology as a triage tool significantly reduced the waiting time for in-person visits, improving health care access and utilizing public resources wisely. Knowledge of sex, age, diagnoses and treatment of common skin conditions can enable public policies for the prevention and orientation of the population, as it can be used to train general physicians to address such cases.

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Section: Discussionmentioning

confidence: 96%

Teledermatology reduces dermatology referrals and improves access to specialists

2020

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“…Telemedicine was effective in screening dermatologic diseases in primary care attention. 11 Previously, we showed that telemedicine was efficient for triage and management of dermatoses in the pediatric age group. 12 In the present study, the majority of patients with atopic dermatitis did not require an in-person visit with the dermatologist or allergist (72%), presumably because they had mild disease.…”

Section: Discussionmentioning

confidence: 99%

Accuracy and efficiency of telemedicine in atopic dermatitis

et al. 2020

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Background: Telemedicine provides accurate diagnoses for skin disorders and has gained emphasis. It may be used for the triage and management of common skin diseases in primary care, improving patients' access and reducing time to treatment. Objective: To evaluate the proportion of atopic dermatitis patients who could be managed with the support of telemedicine and its accuracy. Second, we aimed to assess the frequency of atopic dermatitis, demographics, clinical features, and therapies dispensed in relation to the disease. Methods: Retrospective study in a population of 30,976 individuals, assisted by telemedicine. We assessed patients with the diagnosis of atopic dermatitis and evaluated the proportion of cases referred to biopsy, inperson dermatologists, or to be managed by primary care; the treatments suggested; and telemedicine accuracy to diagnose atopic dermatitis. Results: Atopic dermatitis was diagnosed in 1648 patients (5.3%), the sixth most common dermatosis, with 2058 lesions (3.7%) analyzed. Primary care physicians were able to manage 72% of the atopic dermatitis patients, whereas 28% of them were referred to in-person dermatologists. Accuracy for atopic dermatitis diagnosis was 84.4%. Conclusion: Telemedicine was an accurate method and helped primary care physicians to treat 72% of the atopic dermatitis lesions, thereby optimizing the availability of in-person appointments with dermatologists for more severe cases.

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“…A study by McAfee et al [7] involved the evaluation of 25 Cleveland Clinic Health System walk-in primary care clinics. The researchers investigated a teledermatology e-consultation program that utilized a store-and-forward approach, through which 500 patients received consultation over 517 e-consultations [7]. The median time elapsed from placement in the e-consultation system to completion of consultation was just 1 day [7].…”

Section: Teledermatology's Reliability and Usefulness In Primary Healthcarementioning

confidence: 99%

“…The researchers investigated a teledermatology e-consultation program that utilized a store-and-forward approach, through which 500 patients received consultation over 517 e-consultations [7]. The median time elapsed from placement in the e-consultation system to completion of consultation was just 1 day [7]. In 71% of cases, "teledermatologists" were able to find discordant results to primary care physicians, and in 60% of cases, a change in the treatment plan was recommended [7].…”

Section: Teledermatology's Reliability and Usefulness In Primary Healthcarementioning

confidence: 99%

“…Patients were granted access to board-certified dermatology professionals who, in strictly in-person circumstances, Saudi J Health Syst Res 2021;1:103-107 DOI: 10.1159/000518915 would likely have waited much longer to see. This saved patients' time and expenses and, in some cases, positively affected their health outcomes [7].…”

Section: Teledermatology's Reliability and Usefulness In Primary Healthcarementioning

confidence: 99%

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Teledermatology in the Saudi Arabian Healthcare System: Utilization and Challenges

Dakhil

Altalhab

2021

Saudi J Health Syst Res

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Background: In recent years, telemedicine has led to a dramatic shift in healthcare service delivery, mainly due to the ease with which telemedicine can be integrated into a multitude of specialties and its flexibility as a means of providing care. Over the last 2 decades, technological advancements have made telemedicine integral to healthcare in many countries. In particular, dermatology was benefited from telemedicine as a new tool, thanks to the visual character that pervades this practice. Teledermatology is the interactive practice of remote dermatological assessment, involving live contact with patients (“live interactive”) and data access and retrieval (“store-and-forward”). This review discusses the role of this new discipline in medical education, inpatient care, and primary care through the analysis of several studies addressing this topic. Also examined are the status and limitations of teledermatology in Saudi Arabia and some proposed solutions. Summary: Visual assessment of dermatological conditions is common practice among dermatologists. However, due to the scarcity of specialists in some areas, wait times have been a hindrance for patients requiring an assessment. Teledermatology improves access by reducing wait times, speeding up the referral process, and streamlining assessments. Furthermore, teledermatology effectively serves as a form of triage, particularly for cases of suspected cutaneous malignancy that typically require the shortest referral time. Earlier diagnoses, more effective management of chronic skin disease, and inpatient care are all additional benefits offered by the teledermatology practice. The use of teledermatology is now widespread, with roles extending beyond patient care to medical teaching and training in residency programs. This perhaps reflects physicians’ highly positive perceptions regarding teledermatology; however, patient perception in Saudi Arabia is still lagging behind the global standard, possibly due to privacy concerns. Key Message: Teledermatology can be reliably utilized to advance healthcare services and medical education. Improving patient awareness and perception of this emerging discipline is crucial; to that end, the practice must address privacy concerns. Patient uploads of photographs and videos should be stored on an end-to-end encrypted platform to provide optimal service and encourage patients’ participation. Ultimately, physicians should be well acquainted with the medical, ethical, and technical aspects of teledermatology.

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Store-and-forward teledermatology improves care and reduces dermatology referrals from walk-in clinics: A retrospective descriptive study

Cited by 20 publications

References 5 publications

Teledermatology reduces dermatology referrals and improves access to specialists

Teledermatology reduces dermatology referrals and improves access to specialists

Accuracy and efficiency of telemedicine in atopic dermatitis

Teledermatology in the Saudi Arabian Healthcare System: Utilization and Challenges

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