The challenges of following patients and assessing outcomes in teledermatology

Krupiński, Elizabeth A.; Engstrom, Mike; Barker, Gail; Levine, Norman; Weinstein, Ronald S.

doi:10.1258/135763304322764149

Cited by 24 publications

(19 citation statements)

References 11 publications

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“…In another study, dermatologists responded to store-and-forward consultations in an average of 2.17 days, compared with a mean wait time of 90 days for clinic-based appointments [12]. Two studies confirm that the clinical courses of TD patients and traditionally seen patients are similar [13,14]. Multiple studies have evaluated the proportion of store-and-forward TD consults that avoided, or would have avoided, a clinic visit to a dermatologist (ranging from 18-58%) and cutting in half the number of “urgent” referrals (from 64% to 32%) [15-21].…”

Section: Evaluations Of Tdmentioning

confidence: 99%

Overview of international teledermatology

Desai¹,

McKoy²,

Kovarik³

2011

Pan Afr Med Jrnl

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Teledermatology is essentially “dermatology at a distance”, using one of many communication technologies to expand the reach of a dermatologist to those in need of their specialized knowledge. Most international teledermatology is store-and-forward in nature, a method in which images are stored on a computer and then transmitted electronically to a consulting dermatologist. This system is more convenient and less costly than real-time teledermatology. This review will focus on several of the store-and-forward teledermatology systems being developed and utilized successfully internationally. This discussion of “who” is practicing teledermatology is not comprehensive, but attempts to show some of the breadth of teledermatology practice around the world, including government national health plans, commercial endeavors, and charitable work by individuals and institutions. The goal in many instances is to provide better health outcomes through increased access, efficiency, and/or cost-effectiveness. More studies ultimately need to be conducted to develop a more comprehensive and sustainable model for teledermatology.

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Section: Evaluations Of Tdmentioning

confidence: 99%

Overview of international teledermatology

Desai¹,

McKoy²,

Kovarik³

2011

Pan Afr Med Jrnl

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“…5,14 Our data show that 68% of conditions required only one consultation, although the remaining one-third of conditions (32%) required two or more consultations. The tracking system facilitated treatment, particularly in cases with multiple consultations, by providing a detailed reference for previous treatment recommendation status and/or reasons why the treatment would not be completed (e.g.…”

Section: Discussionmentioning

confidence: 66%

A teledermatology care management protocol for tracking completion of teledermatology recommendations

et al. 2012

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In July 2009 we implemented a 3-year store-and-forward teledermatology project to provide dermatology care to veterans living in rural and underserved areas of the US Pacific Northwest. We also developed a follow-up protocol and tracking system. Information about all completed teledermatology consultations was entered into a database, and major procedures and select medications were tracked. In the first 21 months, 8202 dermatology conditions in 5232 veterans were treated and 3370 major procedures carried out. Ninety-five percent of conditions were associated with no more than two teledermatology consultations, and no condition required more than ten consultations. In total, 1454 conditions were reviewed for clinical pathological correlation, and in 310 (21%) there was a subsequent clinical pathological correlation conference, resulting in a change in final diagnosis for 93 conditions. The follow-up was important in ensuring high quality patient care.

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“…To date, two studies have evaluated clinical outcomes of S&F teledermatology compared to conventional care, and both studies found similar outcomes for each of the two treatment modalities (Krupinski et al, 2004;Pak et al, 2007). Specifically, Pak et al conducted a randomized controlled trial with patients randomly assigned to either conventional face-toface care or teledermatology.…”

Section: Clinical Outcomes For Store-and-forward Teledermatologymentioning

confidence: 99%

Teledermatology: Outcomes and Economic Considerations

Pathipati¹,

Armstrong²

2011

Telemedicine Techniques and Applications

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IntroductionTeledermatology is defined as the provision of dermatologic care through the use of communications technology (Goldyne & Armstrong, 2010). It offers many benefits that include increased access to dermatologic services and potential reduction in costs associated with care. Teledermatology is traditionally categorized into two different models based on the technology that is employed: store-and-forward (S&F) teledermatology, and live, interactive (LI) teledermatology (Goldyne & Armstrong, 2010). While hybrid models (a combination of S&F and LI technology) are practiced at selected institutions, this chapter focuses primarily on S&F and LI models. We will present operational flows of these two technology-enabled modalities, common outcomes measures used for evaluation of teledermatology quality metrics, and economic analyses. At the end of the chapter (in section 5), we will consider a novel, technology-independent framework for categorizing teledermatology models as well. This system relies on classification of teledermatology based on healthcare delivery models, and serves as an alternative way to organize and evaluate the provision of teledermatologic care. Store-and-forward teledermatologyStore-and-forward teledermatology is an asynchronous means for providing dermatologic care, as it relies on the asynchronous transmission of static digital images, patient histories, and specialist recommendations rather than real-time interaction between the specialist and the patient (Goldyne & Armstrong, 2010). In the S&F model, a medical staff personnel at the referral site typically takes images of the relevant skin condition and obtains medical history. This information is then sent to a dermatologist via a secure internet connection. The dermatologist evaluates the patient's condition asynchronously and transmits the recommendations back to the primary care provider at the referral site (Pak et al., 2009). Outcomes measures of store-and-forward teledermatologyTeledermatology studies have assessed numerous outcomes measures, including learning effects, length of consultation, and technical aspects (Eminovic et al., 2007). We will focus this discussion on four extensively used outcomes measures: diagnostic accuracy, diagnostic reliability, clinical outcomes, and satisfaction.

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The challenges of following patients and assessing outcomes in teledermatology

Cited by 24 publications

References 11 publications

Overview of international teledermatology

Overview of international teledermatology

A teledermatology care management protocol for tracking completion of teledermatology recommendations

Teledermatology: Outcomes and Economic Considerations

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