Teledermatology Utilization and Integration in Residency Training Over the COVID-19 Pandemic

Abstract

Background During the 2019 Coronavirus (COVID-19) pandemic, the Division of Dermatology, University of Ottawa, adapted pre-existing local healthcare infrastructures to provide increased provider-to-provider teledermatology services as well as integrated teledermatology into the dermatology residency training program. Objectives (1) To assess the differences in utilization of provider-to-provider teledermatology services before and during the COVID-19 pandemic; and (2) to assess dermatology resident and faculty experiences with the integration of teledermatology into dermatology residency training at the University of Ottawa. Methods We conducted a cross-sectional analysis comparing provider-to-provider teledermatology consults submitted to dermatologists from April 2019 to October 2019 pre-pandemic with the same period during the pandemic in 2020. Two different questionnaires were also disseminated to the dermatology residents and faculty at our institution inquiring about their perspectives on teledermatology, education, and practice. Results The number of dermatologists completing consults, the number of providers submitting a case to Dermatology, and the number of consults initiated all increased during the pandemic period. Ninety-one percent of residents agreed that eConsults and teledermatology enhanced their residency education, enabled continuation of training during the pandemic, and that eConsult-based training should be incorporated into the curriculum. Ninety-six percent of staff incorporated a virtual dermatology practice model, and one-third used teledermatology with residents during the pandemic. Most staff felt there was value in providing virtual visits in some capacity during the pandemic. Conclusions Our study confirms that the use of teledermatology services continues to increase accessibility during the pandemic. Teledermatology enhances the education and training of residents and will be incorporated into dermatology residency programs.

Using the RE-AIM framework to assess national teledermatology expansion

“…The successful implementation of teledermatology by Cohort 2 was fairly robust compared with that of Cohort 1, especially in the face of COVID-19, which was unique to this cohort. In fact, Cohort 2 may have benefited from the focus on telehealth that many healthcare systems, including the VA, turned to during the COVID-19 pandemic ( 24 , 27 – 29 ). Using telehealth at home allowed dermatologists to continue care virtually at a time when many facilities paused in-person visits.…”

“…However, the hubs varied in the education activities that they undertook, and while most focused on provider interactions, one employed a variety of tactics to increase Veteran knowledge and interest in teledermatology. Hubs also trained various types of staff members, including dermatology residents to read images, which likely contributed to the success of their programs ( 27 , 32 , 33 ).…”

Teledermatology for medical education in the COVID-19 pandemic context: A systematic review

“…3 Furthermore, 91% of Canadian dermatology residents would like to have TD being incorporated into their residency curriculum, an opinion concurred by 62% of their faculty members. 4 Surprisingly, only 35% of faculty had incorporated TD into their resident teaching during the pandemic. This is in direct contrast to a global survey that found that the majority of faculty members had used webinars and virtual rounds to facilitate resident teaching.…”