TELEDerm: Implementing store-and-forward teledermatology consultations in general practice: Results of a cluster randomized trial

Hybrid care potential of teledermatology: The importance of linking digital and physical practice and acceptance of online services: A cross-sectional study

Background and Aims

Telemedicine, with Teledermatology, has become a central component of modern medicine. Its importance, especially during the COVID-19 pandemic, underlines its potential to optimize access for dermatological needs. The study aims to assess the potential of teledermatology, understand the importance of linking digital and physical practices, and analyze the adoption of online services based on participants' demographic and experiential factors.

Methods

This cross-sectional survey was conducted among users of the telemedicine platform from July 2022 to March 2023. The platform ("OnlineDoctor") allows users to contact dermatologists for remote dermatological consultations. The survey included questions about the participants' dermatological concerns, their reasons for using teledermatology, their satisfaction with the recommendations and their willingness to continue using telemedicine in the future. Data was collected via the RedCap online platform. Descriptive statistics and regression analyses were carried out.

Results

Overall, 1141 people participated in the study (mean age 44.0 years [SD 14.6], 61.4% women). Results showed that 52.7% of participants with skin conditions had not consulted a dermatologist in the previous year. Shorter waiting times and the lack of face-to-face appointments were the main reasons for using the online platform. In total, 77.6% (n = 885) of participants indicated they would use teledermatology as their first choice if they had an upcoming skin condition. Age, gender, and satisfaction with previous consultations impacted the use of teledermatology as the first choice for future skin conditions.

Conclusion

Teledermatology is characterized by various benefits, including reduced waiting times and improved accessibility to treatment. Nevertheless, the study underscores the importance of a hybrid care approach with direct interaction with the physician. Teledermatology can be transformative in meeting dermatologic needs, mainly when traditional face-to-face consultation is limited. A deep understanding of user preferences and widespread adoption of digital services can pave the way for the successful adoption of teledermatology platforms, improving healthcare accessibility and efficiency.

Digital health interventions in dermatology-Mapping technology and study parameters of systematically identified publications

Digital health interventions (DHI) potentially improve the efficiency and effectiveness of dermatological care. Currently, an overview clustering and characterizing the evidence on DHIs is missing. This systematic mapping of the literature aims to analyse published research on DHIs in dermatology to identify trends and gaps in research. For this purpose, a systematic search of the MEDLINE database was conducted in August 2022 to identify original publications on DHIs in dermatology. Data on country, targeted audience, DHI category, indication, outcome parameter and study design were extracted. Out of 12,009 records identified in MEDLINE, 403 studies were included in the final analysis. Studies on DHIs mainly performed in western countries, headed by the United States (n = 133), Germany (n = 32) and Spain (n = 23). Of all identified DHIs, 261 targeted healthcare providers (HCP), 66 clients (e.g. patients, caregivers, healthy individuals) and 67 both clients and HCPs. A majority of DHIs focussed on establishing a diagnosis (n = 254). Every other study analysed store-and-forward teledermatology (n = 187), followed by artificial intelligence applications for image analysis (n = 65). The most often analysed DHI category for clients was a support of health behaviour change (n = 31). Monitoring of clients was targeted by 77 studies. Skin cancer (n = 148), wounds (n = 29) and psoriasis (n = 29) were the most targeted indications by DHIs. Most studies analysed diagnostic performance (n = 166), fewer studies analysed acceptance (n = 92) and effectiveness (n = 98). Usability (n = 32) and efficiency (n = 36) were investigated only to a small extent. Studies on DHIs in dermatology have focused on teledermatology and AI applications, with an emphasis on skin cancer diagnosis. Apart from that, a range of DHIs for different user groups, purposes and indications were identified, demonstrating the broad potential for DHIs in dermatology. Further research with a wider set of outcome parameters is needed to fully understand the potential of DHIs and ensure their sustainable implementation into dermatological care.