title: Users and nonusers of university-based dermatology services following a teledermatology encounter: a retrospective descriptive analysis.
abstract: OBJECTIVE
  The aim of this study was to retrospectively describe hybrid technology teledermatology encounters performed by a statewide telehealth network. Consult outcomes were reviewed to describe the number of encounters that resulted in a visit to the university-based dermatology clinics and the features of those visits.
  
  
  METHODS
  Teledermatology encounters were reviewed to determine encounter volume and the proportion of encounters that resulted in a university-based dermatology clinic visit. Additional information collected included demographics, the reason for the visit, management recommendations, and clinical diagnoses. After identifying those consults that resulted in a dermatology clinic visit, we reviewed a random sample of teledermatology encounters that did not result in a university-based dermatology clinic visit for a descriptive comparison.
  
  
  RESULTS
  A total of 1,536 teledermatology encounters were completed by the network between 2001 and 2007. Of the 1,307 encounters reviewed, 56 patients were seen in the university-based dermatology clinic after the teledermatology encounter. The need for a procedure or clinic-based intervention was a reason for the visit in 79% of these encounters. When reviewing management recommendations, 46% of the patients who required a university-based clinic visit needed a procedural intervention compared with 8% of the group that did not need a clinic visit. Medical recommendations predominated in the telemedicine-only group (71%) compared with the clinic-based visit group (36%).
  
  
  CONCLUSIONS
  Our study describes the features, such as demographics and case-mix, of users and nonusers of university-based dermatology clinics after teledermatology encounters that may be important considerations for future evaluations of teledermatology consult systems.
authors.affiliation: Department of Dermatology, University of Missouri School of Medicine, Columbia, Missouri, USA.
authors.forename: Karen E
authors.initials: KE
authors.lastname: Edison
authors.forename: Louanne
authors.initials: L
authors.lastname: Chance
authors.forename: Kari
authors.initials: K
authors.lastname: Martin
authors.forename: Kara
authors.initials: K
authors.lastname: Braudis
authors.forename: John D
authors.initials: JD
authors.lastname: Whited
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D003880:Dermatology / Q000458:organization & administration* / Q000706:statistics & numerical data; D005260:Female; D006748:Hospital Departments / Q000458:organization & administration* / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D008923:Missouri; D017060:Patient Satisfaction; D012017:Referral and Consultation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012871:Skin Diseases / Q000175:diagnosis*; D017216:Telemedicine / Q000706:statistics & numerical data*; D014495:Universities / Q000706:statistics & numerical data*; D055815:Young Adult