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Real-time teledermatologic technology improves diagnostic performance

Compared with standard hardware, new-generation mobile devices reduced the cost of videoconferencing, increased the versatility of teledermatology and decreased practitioner time involvement.

Researchers enrolled 111 adults from May 2008 through June 2010 who were consulted consecutively for dermatologic conditions using three research protocols; 83 of the patients (74.8%) were evaluated using videoconferencing technology.

The first protocol involved recording the dermatologists’ and emergency department (ED) physicians’ diagnoses and management using digital photos taken and sent via mobile telephone. Protocol two involved recording the doctors’ diagnoses and management with videoconferencing using the same mobile phone. Protocol three compared the diagnosis and management between the doctors using either still digital photos or videoconferencing.

ED physician diagnoses were confirmed by dermatologists in 34 of 100 cases (30.9%), invalidated in 39 of 110 cases (35.5%), enlarged in 16 of 110 cases (14.5%) and clarified in 20 of 110 cases (18.2%), according to the study.

Videoconferencing confirmed the dermatologist’s photographic diagnosis in 44 of 68 cases (64.7%), invalidated it in 10 of 68 cases (14.7%), enlarged it in 3 of 68 cases (4.4%) and clarified it in 11 of 68 (16.2%).

Overall, the researchers found videoconferencing improved the diagnostic performance in 57 of 83 cases (68.7%; P < 10^-4). In addition, general practitioner access to teledermatologic advice reduced the number of second referrals to a dermatologist by 20.7%, and access to teledermatology reduced costs by 18%.

“Videoconferencing significantly contributed to diagnosis of direct communication between physicians and improvement of the quality of collected information and/or accuracy of the patient’s status evaluation,” the researchers wrote.

Disclosures: Duong received a grant from Basilea Pharm for the first year of her PhD program.