title: Content and style comparison of physician communication in teledermatology and in-person visits.
abstract: BACKGROUND
  The body of research is rapidly growing regarding the use of telemedicine in patient care, including cost-effectiveness, patient access, patient outcomes, etc. Less has been done describing physician communication during different aspects of the clinical visit (i.e., education, assessment, treatment, etc.) during actual versus virtual patient visits. The purpose of this study was to evaluate dermatology healthcare providers' communication via both modalities with regard to content and style.
  
  
  METHODS
  In-person and teledermatology patient visits were observed, audio-recorded, and transcribed over an 8-month period. A content analysis was performed.
  
  
  RESULTS
  The Wilcoxon rank sum test was used to compare the content differences between visit modalities for each category. A p value of 0.05 was considered as significant for all tests. There were no statistically significant differences between modalities in the average number of physician words in seven of eight communication categories: small talk, clinical assessment, psychosocial issues, patient education, patient compliance, patient treatment, and administrative issues (p value range, 0.16-0.91). As well, the same communication themes occurred in each modality to essentially the same degree. For instance, assessment and discussion of treatment occurred in 100% of in-person and teledermatology visits, as did small talk.
  
  
  CONCLUSIONS
  This research indicates that physician providers communicate with similar style and content whether using teledermatology or in-person.
authors.affiliation: Department of Dermatology, University of Missouri, Columbia, MO 65212, USA. edisonk@health.missouri.edu
authors.forename: Karen E
authors.initials: KE
authors.lastname: Edison
authors.forename: David A
authors.initials: DA
authors.lastname: Fleming
authors.forename: Elizabeth Lewis
authors.initials: EL
authors.lastname: Nieman
authors.forename: Kendra
authors.initials: K
authors.lastname: Stine
authors.forename: Louanne
authors.initials: L
authors.lastname: Chance
authors.forename: George
authors.initials: G
authors.lastname: Demiris
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003142:Communication; D003880:Dermatology / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008923:Missouri; D009819:Office Visits / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D036301:Qualitative Research; D013637:Tape Recording; D017216:Telemedicine / Q000706:statistics & numerical data; D055815:Young Adult