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Store-and-forward teledermatology delivers care in PCP settings

Store-and-forward teledermatology can be used successfully to deliver dermatologic care to outpatients in primary care settings with poor resources, according to recently published study results.

Researchers conducted a prospective study of store-and-forward teledermatology consults from primary care physicians at 11 underserved clinics in Philadelphia to dermatologists at the University of Pennsylvania between January and November 2013. The clinics included those focusing on primary care of HIV-positive patients and treatment of STDs, and served patients with a higher than average poverty and uninsured rates.

The consults were transmitted via mobile devices and the Internet. Diagnostic and management concordance between PCPs and dermatologists, time to consult completion, anticipated level of dermatology input in the absence of teledermatology and number of consults managed with teledermatology alone were measured. The AccessDerm mobile store-and-forward platform (Vignet Corp.), a volunteer serviced developed by the American Academy of Dermatology to reach underserved U.S. populations, was used to handle the teledermatolgy consults.

Thirty PCPs submitted 225 consults to nine board-certified dermatologists. There were 196 consults included in the study, which encompassed 206 dermatologic conditions.

“Diagnoses and management plans of [PCPs] and dermatologists were fully concordant for 22% and 23% of conditions, respectively,” the researchers wrote.

There was a median time to consult completion of 14 hours. There were 120 consults (61%) that would not have received dermatology input in the absence of teledermatology, and 150 (77%) consults were managed by teledermatology alone.

“The high proportions of diagnostic and management discordance observed between PCPs and dermatologists in this study support the potential of [store-and-forward] teledermatology to improve not only access to outpatient dermatologic care, but also clinical outcomes in the primary care setting,” the researchers concluded. “We anticipate the further dissemination of existing technologies and the development of novel technologies will enhance the feasibly of teledermatology.” – by Bruce Thiel

Disclosure: The Vignet Corp. provided the AccessDerm software and assistance with technical support. Nelson was involved in the creation of the mobile platform but reports no institutional or corporate affiliations or conflicts of interest. Please see the full study for other researchers’ relevant financial disclosures.