A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology

Vyas, Krishna S.; Hambrick, H Rhodes; Shakir, Afaaf; Morrison, Shane D.; Tran, Dung Duc; Pearson, Keon; Vásconez, Henry C.; Mardini, Samir; Gosman, Amanda; Dobke, Marek; Granick, Mark S.

doi:10.1097/sap.0000000000001044

Cited by 119 publications

(106 citation statements)

References 84 publications

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“…However, the response rates are unknown, and those who responded to the survey might be more used to electronic services than nonresponders. The rapidly developing field of telemedicine holds promise in increasing the efficiency of postoperative care after skin surgery, and the addition of wound photographs to clinical data has been shown to improve accuracy in diagnosing SSIs . As most dermatological procedures are performed as outpatient surgery, postoperative wound assessments through teledermatology might help in the triage and management of complications without the need for extra face‐to‐face visits.…”

Section: Discussionmentioning

confidence: 99%

Variability in the diagnosis of surgical‐site infections after full‐thickness skin grafting: an international survey

et al. 2019

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Summary Background Diagnosis of a surgical‐site infection (SSI) in dermatological surgery can be based entirely on a subjective assessment, according to the fourth criterion of the most common definition of an SSI, which was established by the US Centers for Disease Control and Prevention. Objectives To investigate the interobserver agreement between dermatologists in their diagnosis of SSI of dermatosurgical wounds. Methods An international electronic photographic survey with eight photographs of wounds 1 week after full‐thickness skin grafting (FTSG) was sent to dermatologists. All wounds were assessed in terms of visual criteria beforehand. Data collected from respondents included physician characteristics and experience, and SSI assessments of all wounds. Results In total, 393 dermatologists from 27 countries enrolled. Most respondents were from the U.S.A. (25%), followed by Sweden (24%) and the U.K. (13%). There was only a slight interobserver agreement on SSI suspicion (κ = 0·19). SSI suspicion was lower for male physicians (P = 0·03), board‐certified dermatologists (P = 0·001), physicians regularly assessing surgical wounds (P = 0·03) and physicians performing FTSG (P < 0·001). Swedish physicians diagnosed more SSIs than U.S. physicians (P = 0·002). Erythema was more common in cases with higher SSI suspicion. Conclusions This study reveals broad inter‐rater variability in the diagnosis of SSI, illustrating the need for novel objective diagnostic methods that can better capture the variables that constitute an SSI.

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Section: Discussionmentioning

confidence: 99%

Variability in the diagnosis of surgical‐site infections after full‐thickness skin grafting: an international survey

et al. 2019

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“…With continued advancements in video stream resolution, compression, and data encryption, telemedicine ventures will continue to evolve in their delivery of convenient, efficient, and cost-effective care. 4,[7][8][9] Major barriers facing the broad adoption of telemedicine include service reimbursement, interstate medical licensure, patient confidentiality, clinical concerns regarding quality of the physician-patient relationship and physical examination, and social issues regarding the "digital divide" affecting aging, rural, and lower income populations. 1,2 Current insurance coverage guidelines (e.g., Medicare, Medicaid) do not adequately address the needs of a large-scale platform, but opportunities for telemedicine ventures to experiment with bundled payment plans exist while progress is made in telemedicine reimbursement models.…”

Section: Introductionmentioning

confidence: 99%

“…1,2 Current insurance coverage guidelines (e.g., Medicare, Medicaid) do not adequately address the needs of a large-scale platform, but opportunities for telemedicine ventures to experiment with bundled payment plans exist while progress is made in telemedicine reimbursement models. 1,4,8 Hospitals may further capitalize on platform implementation by creating dedicated telehealth departments composed of physicians and surgeons hired to systematically field remote telecommunication calls. 1,5,10 The mass marketing of smartphones and wearable devices will likely drive the next generation of patient-centered telemedicine.…”

Section: Introductionmentioning

confidence: 99%

“…New platforms will benefit from integrating application-based mobile health and wearable device data, while encouraging digital patient engagement and allowing real-time monitoring and transmission of medical data. 4,11 These units will bring a new dimension to a diverse range of Fig. 1 An electronic otoscope operated here by a nurse has the capabilities to relay high-quality imaging to the tele-physician.…”

Section: Introductionmentioning

confidence: 99%

“…Originally pursued as a mode of increasing access, especially to specialist care, the health care industry now recognizes telemedicine's proven benefits in streamlining interprofessional referral and collaboration, increasing the efficiency of postoperative care, eliminating unnecessary referrals, reducing health care costs, and providing outcomes equal to or better than the current standard of care. 1,3,4 For hospital systems, adoption of telemedicine means an expanded geographic footprint, decreased emergency room (ER) bounce back, and more efficient face-to-face clinic and triage time. For patients, benefits include decreased Keywords ► telehealth ► telemedicine ► technology ► tele-device…”

mentioning

confidence: 99%

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Initiating Telehealth in a Complex Organization

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et al. 2018

Seminars in Plastic Surgery

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Medicine has been praised for breakthroughs that improve the quality and longevity of human life. In the setting of today's fast-paced, tech-savvy society in combination with increased patient volume entering hospital doors, telemedicine proves an effective tool to enable the industry to adapt to the changing world around us. A review of the current literature and legislative laws was conducted along with knowledge from the experience gathered at starting a telehealth platform at Texas Children's Hospital to find the necessary steps for starting a telehealth program. Through digital platform, telemedicine offers remote delivery of medical services to all parts of the country, urban and rural, while enhancing interprofessional referral patterns in the local setting. Telemedicine sets to preemptively triage and guide patients through their appropriate phases of care all the meanwhile, bringing the patient and physician closer together. This discussion delves into the further added benefits to large hospital systems, breaks down the basics of the technological platform, and addresses current barriers to entry in the telehealth industry. This article serves as an introduction to a series regarding effective implementation of telemedicine into the hospital system.

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Perceptions and Use of Telehealth Among Mental Health, Primary, and Specialty Care Clinicians During the COVID-19 Pandemic

et al. 2022

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Key Points Question Are clinician perceptions of telehealth quality associated with use? Findings In this survey study of 866 mental health (MH), primary care (PC), and specialty care (SC) clinicians, MH clinicians rated the quality of video care the highest and were more likely to prefer video over phone when providing care for patients remotely; PC and SC clinicians were more likely to endorse challenges of video care. Findings aligned with utilization rates, with MH clinicians conducting significantly more video visits than PC and SC clinicians. Meaning These findings suggest that specialty-specific differences in clinician perceptions of telehealth were associated with actual use.

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A Systematic Review of the Use of Telemedicine in Plastic and Reconstructive Surgery and Dermatology

Cited by 119 publications

References 84 publications

Variability in the diagnosis of surgical‐site infections after full‐thickness skin grafting: an international survey

Variability in the diagnosis of surgical‐site infections after full‐thickness skin grafting: an international survey

Initiating Telehealth in a Complex Organization

Perceptions and Use of Telehealth Among Mental Health, Primary, and Specialty Care Clinicians During the COVID-19 Pandemic

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