Teledermatology: key factors associated with reducing face-to-face dermatology visits.
Teledermatology makes 3 promises: better, cheaper, and faster dermatologic care. It is "better" because, although it cannot offer as much to the patient as a traditional visit, it extends the dermatologist's reach to places and in ways not previously possible as a result of time and place limitations; it is "cheaper and faster" because it has the potential to reduce costs and increase efficiency for both patients and providers. For teledermatology to fulfill these promises, it must enable dermatologists to improve access by increasing the number of patients evaluated and treated. Increased patient access depends on maximizing a scarce resource-dermatologists' time-in part by avoiding unnecessary and time-consuming face-to-face appointments. We examined the literature to date to determine which teledermatology programs have greater or lesser success in reducing face-to-face visits. Our review highlights 4 factors that are associated with a higher number of face-to-face appointments avoided by teledermatology programs: (1) effective preselection of patients for teleconsultation, (2) high-quality photographic images, (3) dermoscopy if pigmented lesions are evaluated, and (4) effective infrastructure and culture in place to implement teleconsultation recommendations.
Dermatoepidemiology Unit, Providence Veterans Affairs Medical Center, Providence, Rhode Island; Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island. Electronic address: Shoshana.Landow@va.gov.
Shoshana M
SM
Landow
Institute of Medical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts.
Ashley
A
Mateus
Dermatoepidemiology Unit, Providence Veterans Affairs Medical Center, Providence, Rhode Island; University of Michigan Medical School, Ann Arbor, Michigan.
Kaveri
K
Korgavkar
Department of Aeronautics and Astronautics and Engineering Systems, Massachusetts Institute of Technology, Cambridge, Massachusetts.
Deborah
D
Nightingale
Dermatoepidemiology Unit, Providence Veterans Affairs Medical Center, Providence, Rhode Island; Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island; Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Martin A
MA
Weinstock
D001071:Appointments and Schedules; D003880:Dermatology / Q000379:methods*; D046169:Dermoscopy / Q000379:methods; D006801:Humans; D009819:Office Visits / Q000706:statistics & numerical data*; D018579:Patient Selection; D019114:Remote Consultation / Q000706:statistics & numerical data; D017216:Telemedicine
access; appointments avoided; store-and-forward dermatology; teledermatology; telehealth; telemedicine