Black Skin Dermatology Online, from the project to the website: a needed collaboration between North and South

Indian J Dermatol Venereol Leprol

2011

The study and practice of dermatology care using interactive audio, visual, and data communications from a distance is called teledermatology. A teledermatology practice (TP) provides teleconsultation as well tele-education. Initially, dermatologists used videoconference. Convenience, cost-effectiveness and easy application of the practice made "store and forward" to emerge as a basic teledermatology tool. The advent of newer technologies like third generation (3G) and fourth generation (4G) mobile teledermatology (MT) and dermatologists' interest to adopt tertiary TP to pool expert (second) opinion to address difficult-to-manage cases (DMCs) has resulted in a rapid change in TP. Online discussion groups (ODGs), author-based second opinion teledermatology (AST), or a combination of both are the types of tertiary TP. This article analyzes the feasibility studies and provides latest insight into TP with a revised classification to plan and allocate budget and apply appropriate technology. Using the acronym CAP-HAT, which represents five important factors like case, approach, purpose, health care professionals, and technology, one can frame a TP. Store-and-forward teledermatology (SAFT) is used to address routine cases (spotters). Chronic cases need frequent follow-up care. Leg ulcer and localized vitiligo need MT while psoriasis and leprosy require SAFT. Pigmented skin lesions require MT for triage and combination of teledermoscopy, telepathology, and teledermatology for diagnosis. A self-practising dermatologist and national health care system dermatologist use SAFT for routine cases and a combination of ASTwith an ODG to address a DMC. A TP alone or in combination with face-to-face consultation delivers quality care.

Section: Online Discussion Groupsmentioning

confidence: 99%

“…[55] Previous reviews [2,55] suggest SAFT and HT for second opinion TP. Currently, there are three types of tertiary TP: (a) ODG, [56][57][58][59][60][61][62] (b) AST, [18] (c) and the combination of ODG and AST [63] [ Figure 1]. …”

Section: Teledermatopathologymentioning

confidence: 99%

Newer insights in teledermatology practice

Indian J Dermatol Venereol Leprol

2011

“…Most of the studies on ODF [60][61][62][63][64][65][66][67][68] were retrospective analysis. However, ODF is a modification of SAFT and the principles of SAFT matches exactly with ODF.…”

Section: Discussion Discussionmentioning

confidence: 99%

“…MT had four (8%) small studies [56][57][58][59] (Grade 2). There were 17% (9) of feasibility studies on tertiary [60][61][62][63][64][65][66][67][68] (second opinion) teledermatology, three studies [60][61][62] with the gold standard comparison were included and six studies [63][64][65][66][67][68] without a gold standard comparison were excluded for analysis on online discussion forum (ODF). The sub-specialty TP included 4% (2) and 2% (1) studies with the gold standard comparison for pediatric [69][70] and geriatric [71] TP respectively.…”

Section: Methods Methodsmentioning

confidence: 99%

A longitudinal study of consistency in diagnostic accuracy of teledermatology tools

Indian J Dermatol Venereol Leprol

2013

SAFT and VC were adequately validated on a large number of patients by various feasibility studies with the gold standard (face-to-face) comparison between teledermatologists and clinical dermatologists. The DA of SAFT was good, stable over the 15 years and comparable to VC. Health-care providers need to plan for appropriate utility of SAFT either alone or in combination with VC to implement and deliver teledermatology care in India.

“…Second‐opinion teledermatology plays a significant role in delivering quality care in DMC 11,12 . AST is a process to approach a DMC, to identify and track the experts across the globe who have previously studied the instant DMC and published their work, to obtain the literature and interact with authors to share views by sending clinical data using their e‐mail (store and forward teledermatology).…”

Section: Discussionmentioning

confidence: 99%

Authors’ willingness for second‐opinion teledermatology in difficult‐to‐manage cases: ‘an online survey’

2010

Acad Dermatol Venereol

A dermatologist obtains literature, answered queries and constructive suggestions with additional informative material and pools second-opinions from the authors using their e-mail to deliver quality health care. AST is an alternative to online discussion group for second-opinion teledermatology practice in difficult-to-manage cases. Uniform international laws are to be framed to facilitate telemedicine care for a difficult-to-manage case.