Researchers at the University of Pennsylvania, Philadelphia, US, analysed 50 inpatient dermatology consultations between 2012 and 2013. Participants were evaluated separately by a face-to-face consultation with a dermatologist and by two independent teledermatologists. Study outcomes were measured by agreements in initial patient triage decisions and the decision to biopsy.
According to the study results, the teledermatologists agreed in 90% of consultations if the face-to-face dermatologist recommended the patient should be seen the same day, and agreed in 95% of cases if the face-to-face dermatologist recommended a biopsy.
When the teledermatologist did not choose the same course of action, there was substantial diagnostic agreement between the teledermatologist and the face-to-face dermatologist. Teledermatologists were able to triage 60% of consultations to be seen the next day or later, and 10% of patients to be seen as outpatients after discharge.
Teledermatology appears to be reliable for the initial triage of inpatient dermatological consultations and it can potentially increase efficiency. Future studies will need to anticipate further refinement of the model to validate and substantiate stronger concordance and efficiency gains with improving accessibility to dermatologists.
Barbieri JS, Nelson CA, James WD et al. JAMA Dermatol. Published online February 12, 2014. doi:10.1001/jamadermatol.2013.9517