Impact of store-and-forward (SAF) teledermatology on outpatient dermatologic care: A prospective study in an underserved urban primary care setting. J Am Acad Dermatol 2016 Mar;74(3):484-90.e1
Date
12/19/2015Pubmed ID
26679528DOI
10.1016/j.jaad.2015.09.058Scopus ID
2-s2.0-84958184519 (requires institutional sign-in at Scopus site) 66 CitationsAbstract
BACKGROUND: The clinical value of teledermatology in the primary care setting remains relatively unknown.
OBJECTIVE: We sought to determine the impact of teledermatology on outpatient diagnosis, management, and access to dermatologic care in a resource-poor primary care setting.
METHODS: We performed a prospective study of store-and-forward teledermatology consults submitted between January and November 2013 from 11 underserved clinics in Philadelphia to the University of Pennsylvania using mobile devices and the Internet. We assessed diagnostic and management concordance between primary care providers and dermatologists, time to consult completion, anticipated level of dermatology input in the absence of teledermatology, and number of consults managed with teledermatology alone.
RESULTS: The study included 196 consults encompassing 206 dermatologic conditions. Diagnoses and management plans of primary care providers and dermatologists were fully concordant for 22% and 23% of conditions, respectively. The median time to consult completion was 14 (interquartile range 3-28) hours. At least 61% of consults would not otherwise have received dermatology input, and 77% of consults were managed with teledermatology alone.
LIMITATIONS: Lack of a diagnostic gold standard, limited patient follow-up, and uncertain generalizability are limitations.
CONCLUSION: Teledermatology is an innovative and impactful modality for delivering dermatologic care to outpatients in resource-poor primary care settings.
Author List
Nelson CA, Takeshita J, Wanat KA, Bream KD, Holmes JH, Koenig HC, Roth RR, Vuppalapati A, James WD, Kovarik CLAuthor
Karolyn A. Wanat MD Vice Chair, Professor in the Dermatology department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAmbulatory Care
Dermatology
Female
Health Services Accessibility
Humans
Male
Medically Underserved Area
Middle Aged
Philadelphia
Primary Health Care
Prospective Studies
Skin Diseases
Telemedicine
Urban Population
