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Teledermatology for Diagnosis and Management of Skin Conditions

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Teledermatology for Diagnosis and Management of Skin Conditions

Investigators: Erin Warshaw, MD, MS; Research Associates: Nancy Greer, PhD, Yonatan Hillman, BA, Emily Hagel, MS, Roderick MacDonald, MS, and Indulis Rutks, BS. ESP Program Director: Timothy J Wilt, MD, MPH.

Washington (DC): Department of Veterans Affairs; January 2010.

Download PDF: Complete Report, Executive Summary, Report, Appendices

Summary / Overview

Telemedicine uses telecommunication technology to transfer medical information. Due to the visual nature of a skin examination, telemedicine, specifically, teledermatology, may be a valuable tool in the diagnosis and management of dermatologic diseases for patients in rural areas (including rural Veterans Affairs Medical Centers and Community Based Outpatient Clinics) who may not have ready access to a dermatologist. Teledermatology may also be useful in primary care settings to triage cases and limit unnecessary dermatology clinic referrals. Although not the focus of this review, teledermatology may also be used to provide follow-up care or monitoring after an in-person dermatology visit. The objectives of this evidence synthesis project were to systematically review and summarize the scientific literature addressing: teledermatology for the diagnosis and management of skin conditions, clinical outcomes, cost, and implementation.

The systematic literature review addressed the following key questions:

  1.  
    1. How does the accuracy of teledermatology compare to usual care (in-person dermatology) for the diagnosis of skin conditions?
    2. How does the concordance of teledermatology compare to usual care (in-person dermatology) for the diagnosis of skin conditions?
    1. How does the accuracy of teledermatology compare to usual care (in-person dermatology) for clinical management of skin conditions?
    2. How does the concordance of teledermatology compare to usual care (in-person dermatology) for clinical management of skin conditions?
  2. How do clinical outcomes (clinical course, satisfaction, quality of life, visits avoided) of teledermatology compare to usual care (in-person dermatology) for skin conditions?
  3. How does the cost of teledermatology compare to usual care (in-person dermatology)?
  4. What are the key structural and process elements associated with successful implementation of teledermatology and what are the barriers?

See also

Cyber Seminar on Teledermatology for Diagnosis and Management of Skin Conditions

Warshaw EM, Hillman YJ, Greer NL, Hagel EM, MacDonald R, Rutks IR, Wilt TJ. Teledermatology for Diagnosis and Management of Skin Conditions: A Systematic Review. J Am Acad Dermatol. 2010 Oct 29 (Epub ahead of print).