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Chow A, Smith HE, Car LT, Kong JW, Choo KW, Aw AAL, Wong MAME, Apfelbacher C. Teledermatology: an evidence map of systematic reviews. Syst Rev 2024; 13:258. [PMID: 39396040 DOI: 10.1186/s13643-024-02655-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Accepted: 09/02/2024] [Indexed: 10/14/2024] Open
Abstract
BACKGROUND Although the number of teledermatology studies is increasing, not all variables have been researched in equal depth, so there remains a lack of robust evidence for some teledermatology initiatives. This review describes the landscape of teledermatology research and identifies knowledge gaps and research needs. This evidence map can be used to inform clinicians about the current knowledge about teledermatology and guide researchers for future studies. METHODS Our evidence map was conducted according to the Campbell Collaboration checklist for evidence and gap maps. Eight databases were searched (CINAHL, Embase, PubMed, Scopus, Web of Science, Cochrane Library, JBI Database of Systematic Reviews and Implementation Reports, and OpenGray), and only included systematic reviews of teledermatology involving humans published in English; while excluding non-systematic reviews (i.e., abstracts, conference proceedings, editorials, commentaries, or letters). From 909 records, 14 systematic reviews published between 2004 and 2022 were included. Our analysis focused on the systematic reviews' characteristics, dermatological conditions studied, rate of overlap and quality assessment of primary studies reviewed, and main findings reported. RESULTS Teledermatology was reportedly comparable with clinic dermatology and generally accepted by patients as a mode of care delivery for dermatological conditions. However, there are concerns about privacy, communication, completeness of information transmitted, familiarity with the technology, and technical problems. Healthcare professionals were generally satisfied with teledermatology but found telemedicine consultations longer than face-to-face consultations, and less confident in asynchronous teledermatology than conventional consultations. Teledermatology was reportedly more cost-effective than clinic dermatology; especially considering the distance traveled by patients, referral volume to teledermatology, and clinic dermatology costs. Although patients and providers are satisfied with teledermatology, face-to-face dermatology has higher diagnostic and management accuracy. Teledermatology was also used for training medical professionals. Regarding the validity and reliability of teledermatology outcome measures, no significant discussions were found. CONCLUSIONS COVID-19 spotlighted telemedicine in clinical care, and we must ensure telemedicine continually improves with robust research. Further research is necessary for establishing a standardized outcome set, enhancing accuracy, concordance, cost-effectiveness, and safety, comparing teledermatology with non-dermatologist care, examining its effectiveness in non-Western low and middle-income countries, and incorporating patient involvement for improved study design. SYSTEMATIC REVIEW REGISTRATION https://www.researchregistry.com/ (Unique Identifying Number: reviewregistry878).
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Affiliation(s)
- Aloysius Chow
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Helen Elizabeth Smith
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- School of Medicine, Keele University, Staffordshire, UK
| | - Lorainne Tudor Car
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Jing Wen Kong
- National Healthcare Group Polyclinics, Singapore, Singapore
| | | | - Angeline Ai Ling Aw
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Marie Ann Mae En Wong
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Christian Apfelbacher
- Family Medicine and Primary Care, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore.
- Institute of Social Medicine and Health Systems Research, Otto von Guericke University Magdeburg, Leipziger Str. 44, Bldg 2, office 120, Magdeburg, 39120, Germany.
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Xie D, Sullivan J. Teledermatology in Australian public hospital emergency departments: A review. Australas J Dermatol 2024. [PMID: 38837787 DOI: 10.1111/ajd.14327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 05/05/2024] [Accepted: 05/22/2024] [Indexed: 06/07/2024]
Affiliation(s)
- Danica Xie
- Dermatology Department, The Sutherland Hospital, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | - John Sullivan
- Dermatology Department, The Sutherland Hospital, Sydney, Australia
- Faculty of Medicine, University of New South Wales, Sydney, Australia
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3
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Lee CJ, Boyce A, Chequer de Souza J, Evans R. Store-and-forward (asynchronous) doctor-to-dermatologist non-skin cancer specific teledermatology services in Australia: A scoping review. Australas J Dermatol 2024; 65:37-48. [PMID: 37929627 DOI: 10.1111/ajd.14177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/06/2023] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
Store-and-forward teledermatology (SAFT) has become increasingly popular as a means to increase access to specialist care and address healthcare disparities such as those experienced by rural communities. A contemporary systematic overview of the Australian SAFT services and outcomes for all dermatological conditions is missing. This scoping review provides an overview of Australian SAFT models. Twelve studies were identified through web databases, grey literature sites and reference lists of eligible articles. Eligibility criteria included studies evaluating doctor-to-dermatologist Australian SAFT services provided to Australians for all skin conditions but excluded the studies that solely focused on skin cancers. Data on study design, setting, population, SAFT model, referral characteristics, patient, and general practitioner perspectives, diagnostic concordance, and measured outcomes such as follow up, investigation and waiting time were extracted. Quality of the included studies was assessed using CASP tools. Synthesis reveals that SAFT can be used for patients with any dermatological condition, provides more accurate diagnostics compared to cases without dermatologist input, may reduce waiting times for dermatological expertise, and users generally had positive experiences with SAFT. Although results are positive, this review reveals the heterogenous nature of the literature on SAFT in Australia and a need to establish a uniform approach to assessing the outcomes and impacts of such services.
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Affiliation(s)
- Celine Jessica Lee
- College of Medicine and Dentistry, James Cook University, Queensland, Townsville, Australia
| | - Aaron Boyce
- Department of Dermatology, Townsville University Hospital, Douglas, Queensland, Australia
| | - Julia Chequer de Souza
- College of Medicine and Dentistry, James Cook University, Queensland, Townsville, Australia
| | - Rebecca Evans
- College of Medicine and Dentistry, James Cook University, Queensland, Townsville, Australia
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Hines AS, Zayas J, Wetter DA, Bridges AG, Camilleri MJ, McEvoy MT, El-Azhary RA, Goyal DG, Davis MD, Sartori-Valinotti JC. Retrospective analysis of 450 emergency department dermatology consultations: An analysis of in-person and teledermatology consultations from 2015 to 2019. J Telemed Telecare 2021; 29:1357633X211024844. [PMID: 34143696 DOI: 10.1177/1357633x211024844] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Dermatologic complaints are a common reason for emergency department visits. METHODS Retrospective chart review from 1 January 2015 to 31 December 2019. Patients in the Mayo Clinic Emergency Department receiving dermatology consultation were included. RESULTS Dermatitis (24.7%, n = 113), infection (20.4%, n = 93), and drug reaction (10.3%, n = 47) accounted for the majority of diagnoses. Emergency department providers often provide no diagnosis (38%) or a differential diagnosis (22%), and dermatology consultation frequently alters diagnosis (46%) and treatment (83%). Patients receiving in-person consultations are admitted more frequently than those receiving teledermatology consultations (40% vs. 16%, p < 0.001). Primary diagnostic concordance with subsequent dermatology evaluation is high for in-person (94%) and teledermatology (88%) consultations. DISCUSSION This is the largest study of emergency department dermatology consultations in the United States and the first to compare in-person and teledermatology emergency department consultation utilization in clinical practice. These modalities are utilized in a complementary fashion at our institution, with severe dermatologic diagnoses seen in-person. The valuable role of emergency department dermatologists is highlighted by frequent changes to diagnosis and treatment plans that result from dermatology consultation. Furthermore, our data suggest that teledermatology is an effective modality with the potential to expand access to dermatologic expertise in the emergency department setting.
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Affiliation(s)
- Alexander S Hines
- Department of Internal Medicine, 6915Mayo Clinic, Rochester, MN, USA
| | - Jacqueline Zayas
- Mayo Clinic School of Medicine and the Mayo Clinic Medical Scientist Training Program, Rochester, MN, USA
| | - David A Wetter
- Department of Dermatology, 6915Mayo Clinic, Rochester, MN, USA
| | - Alina G Bridges
- Department of Dermatology, 6915Mayo Clinic, Rochester, MN, USA
| | | | - Marian T McEvoy
- Department of Dermatology, 6915Mayo Clinic, Rochester, MN, USA
| | | | - Deepi G Goyal
- Department of Emergency Medicine, 6915Mayo Clinic, Rochester, MN, USA
| | - Mark Dp Davis
- Department of Dermatology, 6915Mayo Clinic, Rochester, MN, USA
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Edwards HA, Shen X, Soyer HP. Teledermatology Adaptations in the COVID-19 Era. Front Med (Lausanne) 2021; 8:675383. [PMID: 34124105 PMCID: PMC8187587 DOI: 10.3389/fmed.2021.675383] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 04/21/2021] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 pandemic has required health services worldwide to adapt to dramatically changing healthcare needs and risks across all medical specialties. In the dermatology department at Princess Alexandra Hospital, Brisbane, Australia, we developed and implemented a teledermatology system with 1 week's notice to help reduce infection risk bidirectionally, while saving patients many hours of travel and waiting time with acceptable technological substitutes for the clinical encounters. In this study, we report the efficacy and tolerability of our telephone consultation and store and forward imaging system, including patient experience from validated survey data. Our design, implementation and usage of a remote-default system provides experience and lessons to draw upon in developing future telemedicine systems to address dermatology service maldistribution – an issue affecting large areas of Australia – as well as preparedness for future infection mitigation requirements.
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Affiliation(s)
- Harrison A Edwards
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,School of Public Health, University of Queensland, Herston, QLD, Australia.,Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
| | - Xiaohua Shen
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - H Peter Soyer
- Princess Alexandra Hospital, Woolloongabba, QLD, Australia.,Dermatology Research Centre, The University of Queensland Diamantina Institute, The University of Queensland, Brisbane, QLD, Australia
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A process modelling approach to assess the impact of teledermatology deployment onto the skin tumor care pathway. Int J Med Inform 2020; 146:104361. [PMID: 33348274 DOI: 10.1016/j.ijmedinf.2020.104361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/30/2020] [Accepted: 12/01/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Teledermatology was raised as a potential answer to increase access and decrease delay for skin cancer management. However, its influence on non-melanoma skin cancer (NMSC) care pathway has never been studied. OBJECTIVES To compare conventional care pathway to teledermatology (TD) in NMSC care pathways using a process modelling approach. PATIENTS AND METHODS A period study including three groups was conducted in a department of dermatology. During the first period from January till February 2013 a NMSC care pathway was mapped for a group a prior TD integration. During the second period from September 2016 till October 2018, the NMSC care pathway was determined for patients managed by a conventional care process and after TD diagnosis. Patients characteristics, type of tumors and processes were compared using time as a key performance indicator. Mean were reported with their ± SD. Linear regression was performed using time between multidisciplinary consultation and surgery as outcome adjusted on sex, age and cancer type. RESULTS During the first period (prior to TD) 89 NMSC patients were managed (mean age = 76 yr old ± 13) during the second period, 36 patients NMSC were managed after TD, mean age of 89 years old ± 6 and 954 patients in a conventional process, mean age of 78 years old ±12. In comparison between the two periods patient's age, sex and cancer distribution significantly differed while the rate of surgery was not significantly different (p = 0.967). Linear multivariate regression using time between multidisciplinary consultation and surgery as outcome adjusted on sex age and cancer type displayed that during the second period patients in the TD group spent 17.6 days more [0.98,34.25] while patient in the conventional care process group had 9.8 days [1.85,17.74] more than patient in the study period 1, (p = 0.04, p = 0.02) without significant difference for age and sex (p = 0.29, p = 0.51). Patients with a SCC had a decreased time between multidisciplinary consultation and surgery of -12.97 days [-17.43, -8.5], p < 10-3. CONCLUSION Interestingly, patients managed by TD were significantly older than those managed using a conventional care pathway. Unexpectedly their total time spent in the process was not shorter. The results of this analysis illustrated the interest of using process modelling approach to assess the impact of a healthcare innovation integration and to further rethink coordination and care pathways for NSMC post TD.
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7
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Villa L, Matz O, Olaciregui Dague K, Kluwig D, Rossaint R, Brokmann JC. The assessment of dermatological emergencies in the emergency department via telemedicine is safe: a prospective pilot study. Intern Emerg Med 2020; 15:1275-1279. [PMID: 32248403 DOI: 10.1007/s11739-020-02323-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 03/24/2020] [Indexed: 10/24/2022]
Abstract
The aim of the study was to examine the feasibility and safety of telemedicine for dermatological emergency patients in the emergency department. This observational study was monocentric, open, prospective and two-arm randomized [control group (n = 50) and teledermatology group (n = 50)]. The control group was conventionally recruited directly by a dermatologist. In the teledermatology group patients, images of the skin lesions and clinical parameters were transferred to a tablet PC (personal computer) by an emergency physician and telemedically assessed by a dermatologist without patient contact. Subsequently, the dermatologist, who was previously telemedically contacted, then personally examined the patient in the emergency department. The treatment time between the control group and the teledermatology group was also recorded and compared. The agreement in suspected diagnosis between teledermatological evaluation and clinical evaluation of the same physician in the teledermatology group was 100%. The treatment time [mean (minutes) ± standard deviation] of the control group was 151 ± 71, that of the teledermatology group was 43 ± 38 (p < 0.001). The use of emergency telemedicine is safe and effective and provides a viable alternative for clinical care of emergency patients.
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Affiliation(s)
- Luigi Villa
- Emergency Department, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany
| | - Oliver Matz
- Emergency Department, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany.
- Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany.
| | - Karmele Olaciregui Dague
- Department of Neurology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany
| | - David Kluwig
- Department of Dermatology and Allergology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany
| | - Rolf Rossaint
- Department of Anaesthesiology, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany
| | - Jörg Christian Brokmann
- Emergency Department, University Hospital, Rheinisch-Westfälische Technische Hochschule [RWTH] Aachen, Aachen, Germany
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8
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Martin A, Guitera P. Teledermatology for Skin Cancer: The Australian Experience. CURRENT DERMATOLOGY REPORTS 2020. [DOI: 10.1007/s13671-020-00291-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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9
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[Teledermatology for emergency patient care : Two-year experience with teledermatological emergency care]. Hautarzt 2019; 70:324-328. [PMID: 30969350 DOI: 10.1007/s00105-019-4384-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Internationally telemedicine has become an important element of health care. Up to now it plays, however, a minor role in the German health care system. Taking skin diseases as an example we examined over a 2‑year period whether teledermatology is appropriate to care for patients presenting to the emergency department (ED) with symptomatic skin diseases. METHODS During 2016 and 2017, 190 patients aged between 18 and 88 years with skin diseases who presented to the ED of the University Medicine Greifswald (UMG) were cared for by a core team consisting of surgeons who were supported by the on-call dermatologist of the UMG via teledermatology (mSkin Doctor®, InfoKom, Neubrandeburg, Germany). Patients presented nearly exclusively outside the regular working hours: 59% on weekends and public holidays, 39% after 4 p.m. on working days. Furthermore, 33% of patients came from rural areas (<10,000 inhabitants), 41% from regional centres or mid-sized centres. Patients travelled 23 km (median) from their homes to the emergency department. RESULTS In all, 59 of the 190 patients immediately assessed the teledermatology-based care they received in the emergency department: 76% of the patients felt that they had received adequate care, 81% trusted the medical decisions. The teledermatologically based care outside normal working hours was deemed appropriate by 68% of the patients; 32% of the patients, however, wanted the dermatologist to be present at any time at day and night. CONCLUSION Patients with skin diseases were cared for safely by the core team of the ED which was supported by the on-call dermatologist via teledermatology. The use of teledermatology within the context of emergency-based care has gained a high degree of patients' acceptance and confidence.
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Peracca SB, Jackson GL, Weinstock MA, Oh DH. Implementation of Teledermatology: Theory and Practice. CURRENT DERMATOLOGY REPORTS 2019. [DOI: 10.1007/s13671-019-0252-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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Anstey A, Finlay A. Dermatology outpatient care in the U.K.: modernizing services requires patients as our partners. Br J Dermatol 2019; 180:968-970. [DOI: 10.1111/bjd.17688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A.V. Anstey
- Cardiff University, School of Medicine Heath Park Cardiff CF14 4XN U.K
- Betsi Cadwaladr University Heath Board Ysbyty Gwynedd Bangor Gwynedd LL57 2PW U.K
| | - A.Y. Finlay
- Cardiff University, School of Medicine Heath Park Cardiff CF14 4XN U.K
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Lee KJ, Finnane A, Soyer HP. Recent trends in teledermatology and teledermoscopy. Dermatol Pract Concept 2018; 8:214-223. [PMID: 30116667 PMCID: PMC6092076 DOI: 10.5826/dpc.0803a13] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/21/2018] [Indexed: 11/28/2022] Open
Abstract
Teledermatology is a useful alternative where specialized dermatological assistance is not available and has been used successfully to support health professionals in a wide range of settings worldwide, in either an asynchronous store-and-forward format or a real-time video conferencing format. Teledermoscopy, which includes dermoscopic images in the teleconsultation, is another addition that improves remote assessments of pigmented lesions. A more recent variant is mobile teledermoscopy, which uses a smartphone to deliver the same type of service. Teledermoscopy’s greatest strength may be as a triage and monitoring tool, as it can reduce the number of unnecessary referrals, wait times, and the cost of providing and receiving dermatological care. While face-to-face (FTF) care remains the gold standard for diagnosis, drawbacks of not using FTF care as the primary method can be mitigated if teleconsultants are willing to refer to FTF care whenever there is uncertainty. Teledermatology has generally been well accepted by patients and practitioners alike. Barriers to the large-scale use of teledermatology remain. Assigning medicolegal responsibility and instituting a reimbursement system are critical to promoting widespread use by medical professionals, while privacy and security features and a mechanism to link teleconsultations to patients’ existing health records are essential to maximize patient benefit. Direct-to-consumer services also need attention from regulators to ensure that consumers can enjoy the benefits of telemedicine without the dangers of unregulated or untested platforms.
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Affiliation(s)
- Katie J Lee
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia
| | - Anna Finnane
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia.,The University of Queensland, School of Public Health, Herston, Australia
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland Diamantina Institute, Translational Research Institute, Brisbane, Australia.,Department of Dermatology, Princess Alexandra Hospital, Brisbane, Australia
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Augustin M, Wimmer J, Biedermann T, Blaga R, Dierks C, Djamei V, Elmer A, Elsner P, Enk A, Gass S, Henningsen M, Hofman-Wellenhof R, von Kiedrowski R, Kunz HD, Liebram C, Navarini A, Otten M, Reusch M, Schüller C, Zink A, Strömer K. Praxis der Teledermatologie. J Dtsch Dermatol Ges 2018; 16 Suppl 5:6-57. [DOI: 10.1111/ddg.13512] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Matthias Augustin
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Johannes Wimmer
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | - Tilo Biedermann
- Hautklinik Campus Biederstein; Technische Universität München, München
| | - Rolf Blaga
- Psoriasis Selbsthilfe Arbeitsgemeinschaft e. V.; Berlin
| | | | | | - Arno Elmer
- Hochschule für Ökonomie und Management Berlin, Berlin
| | - Peter Elsner
- Klinik für Hautkrankheiten; Universitätsklinikum Jena, Jena
| | - Alexander Enk
- Hautklinik; Universitätsklinikum Heidelberg, Heidelberg
| | | | - Maike Henningsen
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | | | | | | | | | | | - Marina Otten
- Institut für Versorgungsforschung in der Dermatologie und bei Pflegeberufen (IVDP); Universitätsklinikum Hamburg-Eppendorf (UKE), Hamburg
| | | | | | - Alexander Zink
- Dermatologischen Universitätsklinik; Technischen Universität München, München
| | - Klaus Strömer
- Gemeinschaftspraxis für Dermatologie und Allergologie; Mönchengladbach
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Snoswell CL, Whitty JA, Caffery LJ, Finnane A, Soyer HP. What do Australian dermatologists expect to be paid for store-and-forward teledermoscopy? A preliminary investigation. J Telemed Telecare 2018; 25:438-444. [DOI: 10.1177/1357633x18776766] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction Determining appropriate remuneration for teledermoscopy service is important because inadequate remuneration can be a barrier to practitioner uptake and participation. This study explores dermatologist remuneration expectations for a single lesion store-and-forward teledermoscopy consultation. Methods Fourteen dermatologists participated in telephone interviews during May–June 2017. Questions regarding remuneration focused on a clinical scenario involving teledermoscopy of a single lesion suspected to be skin cancer. The initial scenario was an existing patient, with a provisional diagnosis of benign neoplasm from the images, to be followed-up with routine skin checks, taking three minutes to review. Participants indicated their remuneration expectation by selecting from an ascending array of pre-determined remuneration ranges. The question was repeated a further four times with one aspect of the scenario changed each time; consultation length, source (patient or general practitioner), required follow-up, and a new rather than existing patient. Participants were also asked how appropriate they thought teledermoscopy was for the scenario, and whether they would choose to undertake the consultation presented. Results Nine dermatologists selected the AU$61–90 or AU$91–120 remuneration ranges for the initial scenario. When given the opportunity to comment on teledermoscopy service provision in Australia, respondents reflected that it was a valuable, advanced dermatology service, but they would prefer face-to-face consultation with patients where possible to allow for a full body examination. Discussion Dermatologists expect to be remunerated in the range of AU$61–120 for a single lesion store-and-forward teledermoscopy consultation when face-to-face examination is not possible.
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Affiliation(s)
| | - Jennifer A Whitty
- School of Pharmacy, The University of Queensland, Australia
- Health Economics Group, University of East Anglia, UK
| | - Liam J Caffery
- Centre for Online Health, The University of Queensland, Australia
| | - Anna Finnane
- Dermatology Research Centre, The University of Queensland, Australia
- School of Public Health, The University of Queensland, Australia
| | - H Peter Soyer
- Dermatology Research Centre, The University of Queensland, Australia
- Dermatology Department, Princess Alexandra Hospital, Australia
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Chan MYL, Oakley A. Do pictures say a thousand words: Email referrals for dermatology advice at Waikato Hospital. Australas J Dermatol 2017; 59:e81-e82. [PMID: 28762480 DOI: 10.1111/ajd.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Amanda Oakley
- Dermatology Department, Meade Clinical Centre Level One, Waikato Hospital, Waikato District Health Board, Hamilton, New Zealand
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Trettel A, Eissing L, Augustin M. Telemedicine in dermatology: findings and experiences worldwide - a systematic literature review. J Eur Acad Dermatol Venereol 2017; 32:215-224. [PMID: 28516492 DOI: 10.1111/jdv.14341] [Citation(s) in RCA: 100] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Accepted: 03/29/2017] [Indexed: 01/28/2023]
Abstract
Telemedicine has become an important element of health care in many countries and profited from the technological progress of the last two decades. Due to the visual character of the dermatological specialty, teledermatology in particular participated in that development and is becoming a major tool in dermatological consultation. The objective of this article was to identify the use of teledermatology across the world based on published original articles. A systematic literature search of the MEDLINE and Embase databases for eligible publications (predefined inclusion and exclusion criteria) and a cross-validation search were conducted. Search results were reviewed systematically. The search resulted in 204 publications meeting the inclusion criteria for analysis. The highest number of published studies on teledermatology was performed in the United States, followed by the United Kingdom, Spain, the Netherlands, Italy and Austria. The majority of dermatological indications for telemedical consultations were not specified or included various kinds of skin diseases, followed by skin cancer and wounds. Research questions predominantly focused on concordance, effectiveness and cost-effectiveness to determine the value. Teledermatology proved to be a reliable consultation tool in the majority of studies. If specified, telemedicine was used in daily dermatological routine for patient management purposes, to consult patients in peripheral locations, or for medical support in nursing homes or home care settings. The application of teledermatology worldwide is highest in North American and European countries, while countries with poor geographical distribution of physicians seem to be under-represented in teledermatological use, as concluded from publication output. Regarding indications, comparison with classic consultation and area of application, most studies were of general nature. For precise determination of the value, systematic studies would be needed. However, teledermatology is already accepted as a valid tool.
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Affiliation(s)
- A Trettel
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - L Eissing
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
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A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology. Ann Plast Surg 2017; 78:736-768. [DOI: 10.1097/sap.0000000000001044] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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18
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Abbott LM, Magnusson RS, Gibbs E, Smith SD. Smartphone use in dermatology for clinical photography and consultation: Current practice and the law. Australas J Dermatol 2017; 59:101-107. [DOI: 10.1111/ajd.12583] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/02/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Lisa M Abbott
- Sydney Law School; University of Sydney; Sydney New South Wales Australia
| | - Roger S Magnusson
- Sydney Law School; University of Sydney; Sydney New South Wales Australia
| | - Emma Gibbs
- NHMRC Clinical Trials Centre; University of Sydney; Sydney New South Wales Australia
| | - Saxon D Smith
- The Dermatology and Skin Cancer Centre; Gosford New South Wales Australia
- Department of Dermatology; Royal North Shore Hospital; St Leonards New South Wales Australia
- Northern Clinical School; Sydney Medical School; University of Sydney; Sydney New South Wales Australia
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