Teledermatology in the United States: An Update in a Dynamic Era

Yim, Kaitlyn; Florek, Aleksandra G.; Oh, Dennis H.; McKoy, Karen; Armstrong, April W.

doi:10.1089/tmj.2017.0253

Cited by 67 publications

(49 citation statements)

References 31 publications

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“…The dissemination and implementation of teledermatology have grown slowly over the past few decades McKoy et al, 2016;Whited, 2015;Yim et al, 2018). With improvement in imaging and communications technology, the diagnostic accuracy of teledermatology has improved steadily.…”

Section: Discussionmentioning

confidence: 99%

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

Armstrong

Ford

Chambers

et al. 2019

Journal of Investigative Dermatology

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This 12-month, pragmatic, randomized controlled equivalency trial evaluated whether an online, collaborative connected-health model results in equivalent improvements in quality of life compared with in-person care for psoriasis. Overall, 296 adults with physician-diagnosed psoriasis from ambulatory clinics were randomly assigned to either online or in-person care; all were analyzed for outcomes. In the online group, patients and primary care providers sought dermatologists' care directly and asynchronously online. The in-person group sought care face to face. Interventions did not allow blinding of participants; investigators were blinded during analysis. Across 12 months, for the online group, the mean AE standard deviation decline in Skindex-16 from baseline across follow-up visits was 9.02 AE 20.67 compared with 10.55 AE 23.50 for the in-person group. The difference in Skindex-16 between the two groups was e0.83 (95% confidence interval ¼ e5.18 to 3.51), and this was within the equivalence margin (AE7.0). For the online group, the mean AE standard deviation decline in Dermatology Life Quality Index was 1.64 AE 4.34 compared with 1.18 AE 4.77 for the in-person group. The difference in Dermatology Life Quality Index between the two groups was e0.45 (95% confidence interval ¼ e1.29 to 0.38) and was within the equivalence margin (AE2.5). In conclusion, the online model was as effective as inperson care in improving quality of life among psoriasis patients. This study was funded by the Patient-Centered Outcomes Research Institute and is registered on clinicaltrials.gov (NCT02358135).

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Section: Discussionmentioning

confidence: 99%

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

Armstrong

Ford

Chambers

et al. 2019

Journal of Investigative Dermatology

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“…SAF uses asynchronous communication meaning the referrer and the provider do not need to be present at the same time. SAF is the most commonly practised modality of teledermatology in the United States and Spain . SAF has been used effectively for a large range of skin conditions and contexts.…”

Section: Teledermatology Practicementioning

confidence: 99%

A review of literature supporting the development of practice guidelines for teledermatology in Australia

et al. 2020

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Despite the potential of teledermatology to increase access to dermatology services and improve patient care, it is not widely practised in Australia. In an effort to increase uptake of teledermatology, Australian-specific practice guidelines for teledermatology are being developed by the Australasian College of Dermatologist. This paper reports finding from literature reviews that were undertaken to inform the development of these guidelines. Results cover the following sections: Modalities of teledermatology; Patient selection and consent; Imaging; Quality and safety; Privacy and security; Communication; and Documentation and retention. The document educates providers about the benefits and limitations of telehealth while articulating how to enhance patient care and reduce risk when practicing teledermatology.

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“…Globally, there are several established successful TD programmes in the USA, the Netherlands and Spain, which have been well documented . However, there is a paucity of published literature on TD systems from the UK.…”

Section: Introductionmentioning

confidence: 99%

“…In the Netherlands, TD has been fully integrated into and reimbursed by the national healthcare system since 2006 . In the USA, there are multiple large‐scale TD programmes, which are mostly reimbursed by private providers, and a recent survey showed that there are 40 active nongovernmental TD programmes in the USA, with a median annual consultation volume comparable to 263 consultations . The Spanish TD network was established in 2004 in Andalusia for skin cancer referrals, and has led to validated improvements in waiting times and rapid reliable screening for skin cancer .…”

Section: Introductionmentioning

confidence: 99%

A 14‐year review of a UK teledermatology service: experience of over 40 000 teleconsultations

2019

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Background. There is a paucity of published evidence of established teledermatology (TD) services in the UK. An in-house TD service using store-and-forward technology was set up at a large regional dermatology department in 2004. Aim. To review the TD service at our centre, including teleconsultation numbers, coding of diagnoses and patient outcomes. Methods. Retrospective data were retrieved using the electronic patient database, from 31 July 2004 to 31 July 2018. More detailed information on patient outcomes was obtained from patient notes and histology records. A paper questionnaire was distributed to 100 patients to obtain patient feedback. Results. In total, 40 201 teleconsultations were made over 14 years, and 64% of cases were coded (n = 25 555), of which 77% were lesions. The most common coded lesions were benign naevus (25%), seborrhoeic keratosis (22%) and basal cell carcinoma (19%). Of the total number of cases, 50% were discharged to their general practitioner with advice, 34% were booked for surgery and 16% were booked for a face-to-face appointment. In the survey, 82% of patients surveyed felt that the service was 'good' or 'very good'. A detailed study between 1 January 2015 and 1 January 2016 showed that there were 383 patients (10%) with no diagnosis made following teleconsultation, suggesting diagnostic uncertainty. Reasons for this included lack of diagnostic features, possibility of malignancy and service factors. Within this cohort, there was 68% diagnostic concordance. Conclusions. We have set up a successful TD service at a UK centre, which has prevented 16 282 face-to-face appointments over 14 years. Patient feedback has been very good. Review of cases with diagnostic uncertainty provides important information for service improvement and has not previously been documented.

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Teledermatology in the United States: An Update in a Dynamic Era

Cited by 67 publications

References 31 publications

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

Online Care Versus In-Person Care for Improving Quality of Life in Psoriasis: A Randomized Controlled Equivalency Trial

A review of literature supporting the development of practice guidelines for teledermatology in Australia

A 14‐year review of a UK teledermatology service: experience of over 40 000 teleconsultations

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