Live interactive teledermatology compared to in‐person care – a systematic review

Andrees, Valerie; Klein, Toni Maria; Augustin, Matthias; Otten, Marina

doi:10.1111/jdv.16070

Cited by 39 publications

(37 citation statements)

References 44 publications

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“…Recent reviews have shown exceptional diagnostic concordance with store-and-forward teledermatology [38,39]. A review published in 2019 by Andrees et al showed that live-interactive teledermatology was similarly time effective and accurate [40].…”

Section: Discussionmentioning

confidence: 99%

Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review

2020

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Remote consultations likely will grow in importance if the COVID-19 pandemic continues. This review analyzes which methods of teledermatology patients prefer by categorizing how recent studies have defined satisfaction, conducted surveys and concluded patients respond to the different modalities of teledermatology. Using PubMed and Cochrane databases, we reviewed studies from April 5th, 2010 to April 5th, 2020 that included the search terms patient satisfaction and teledermatology. All studies that included patient satisfaction as an outcome were included, but studies not published in English were excluded. We examined domains of satisfaction, survey method, study characteristics (including patient population, country, age, study design and evidence score), findings and statistical comparisons. We thoroughly reviewed 23 studies. Definitions of satisfaction varied, but all concluded patients were satisfied with the live-interactive and store-and-forward modalities. The studies reveal that store-and-forward is appropriate for clinicians with established patients who require regular followup. Verified areas of care include treatment of chronic conditions, topical skin cancer therapy, wound monitoring, and postprocedural follow-up. Only four studies conducted statistical analyses. One of those studies compared patient preference for each modality of teledermatology with face-to-face dermatology. While this study reported high satisfaction with each mode of teledermatology, patients still preferred face-to-face. Favorable responses to remote diagnostic capabilities suggest that these offerings improve preference for teledermatology. With only one study evaluating preference between each modality and face-to-face dermatology, more studies should address the discrepancy. Surveys that cover all domains of satisfaction may improve assessments and identify where gaps in preference exist.

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Section: Discussionmentioning

confidence: 99%

Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review

2020

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“…Although appealing, several factors may hinder the sustainable use of telemedicine. First, providers prefer in-person encounters to virtual ones [ 6 ]. Potential concerns include uncertainty in the clinical encounter, difficulties performing a physical examination, and concerns with the patient-provider relationship [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation

García-Huidobro¹,

Rivera²,

Chang³

et al. 2020

J Med Internet Res

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Background As the COVID-19 pandemic disrupted medical practice, telemedicine emerged as an alternative to outpatient visits. However, it is not known how patients and physicians responded to an accelerated implementation of this model of medical care. Objective The aim of this study is to report the system-wide accelerated implementation of telemedicine, compare patient satisfaction between telemedicine and in-person visits, and report provider perceptions. Methods This study was conducted at the UC Christus Health Network, a large private academic health network in Santiago, Chile. The satisfaction of patients receiving telemedicine care in March and April 2020 was compared to those receiving in-person care during the same period (concurrent control group) as well as in March and April 2019 (retrospective control group). Patient satisfaction with in-person care was measured using the Net Promoter Score (NPS) survey. Patient satisfaction with telemedicine was assessed with an online survey assessing similar domains. Providers rated their satisfaction and responded to open-ended questions assessing challenges, strategies used to address challenges, the diagnostic process, treatment, and the patient-provider relationship. Results A total of 3962 patients receiving telemedicine, 1187 patients from the concurrent control group, and 1848 patients from the retrospective control group completed the surveys. Satisfaction was very high with both telemedicine and in-person services. Overall, 263 physicians from over 41 specialties responded to the survey. During telemedicine visits, most providers felt their clinical skills were challenged (61.8%). Female providers felt more challenged than male providers (70.7% versus 50.9%, P=.002). Surgeons, obstetricians, and gynecologists felt their clinical skills were challenged the least, compared to providers from nonsurgical specialties (P<.001). Challenges related to the delivery modality, diagnostic process, and patient-provider relationship differed by provider specialty (P=.046, P<.001, and P=.02, respectively). Conclusions Telemedicine implemented in response to the COVID-19 pandemic produced high patient and provider satisfaction. Specialty groups perceived the impact of this new mode of clinical practice differently.

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“…However, teledermatology has been shown to be as effective as in-person care, even if the studies thus far have been focused on those done in a dermatology specialist setting. Further studies are needed to compare remote dermatologic assessment with in-person care in a primary care setting performed by GPs [ 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report

et al. 2020

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Background Several recent studies suggest the possibility of a skin rash being a clinical presentation of coronavirus disease 2019 (COVID-19). The purpose of this case report is to bring attention to skin manifestations in the early stage of COVID-19 in order to support frontline physicians in their crucial activity of case identification. Case presentation The patient is an Italian 32-year-old female nurse who had several close contacts with multiple patients with COVID-19 as part of her professional workload. On March 13, 2020, the patient developed an itchy, erythematous papular rash (sparing only her face, scalp, and abdomen), which lasted for 10 days. The rash was accompanied by a feeling of general fatigue that gradually worsened over the following days and has continued for 5 months (until the end of July 2020). During the first week of remote assessment carried out by her general practitioner, the patient gradually developed a dry cough, intermittent fever, and diarrhoea and then had a positive test result for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Her skin manifestations disappeared completely 48 days after the onset of the disease, followed by the disappearance of the dry cough. Conclusions In light of recent studies, this case report suggests that skin manifestations, when taken into account with other situational factors (such as profession and patient history) should be taken into proper consideration by frontline physicians as possibly being caused by SARS-CoV-2. Early identification of COVID-19 is a key part of the strategy of case detection and case isolation. To enhance this activity, further research is needed to establish frequency, symptoms, signs, and pathogenesis of skin manifestations in patients with COVID-19.

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Live interactive teledermatology compared to in‐person care – a systematic review

Cited by 39 publications

References 44 publications

Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review

Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review

System-Wide Accelerated Implementation of Telemedicine in Response to COVID-19: Mixed Methods Evaluation

An itchy erythematous papular skin rash as a possible early sign of COVID-19: a case report

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