Patient and provider experience and outcomes with synchronous teledermatology during the COVID-19 pandemic

Evolving teledermatology policy and reimbursement landscape in the United States

“…Synchronous teledermatology has demonstrated high diagnostic and management concordance with in-person visits, 9 , 20 , 21 , 22 with high patient and provider satisfaction. 6 , 8 , 23 , 24 , 25 , 26 However, it will be important to identify which conditions and patient scenarios are most amenable to synchronous teledermatology visits. 1 , 6 , 8 , 27 Current evidence suggests diagnosis and initial management of typical presentations of common rashes (eg, psoriasis, atopic dermatitis, acne, and rosacea) as well as follow-up care, medication monitoring, and prescription refills for established diagnoses can often be resolved during synchronous teledermatology visits.…”

“… 13 , 28 , 29 In contrast, full-body skin examinations or evaluation of lesions concerning for malignancy may be better suited for in-person appointments, which permit dermoscopy and biopsy procedures. 9 , 13 , 28 , 29 , 30 , 31 Synchronous visits may also create technological difficulties for patients, 6 , 26 which can lower the image quality and contribute to increased time per appointment. 8 , 32 , 33 These difficulties may increase providers’ workload 33 , 34 and it will be important to provide infrastructural support to optimize workflows, such as identifying patients suitable for virtual care, appropriate telehealth to in-person visit ratios, and standardizing history taking typically done by medical assistants.…”

“…In addition to providing high-quality care, teledermatology improves patient access 26 , 30 , 37 , 38 , 39 , 40 and helps to mitigate the shortage 41 , 42 and geographic misdistribution 43 , 44 of dermatologists. 42 While there are potential concerns for telemedicine leading to healthcare overutilization, 27 the total number of outpatient visits, inclusive of telemedicine encounters, has remained below prepandemic levels.…”

National Psoriasis Foundation Telemedicine Task Force guidance for management of psoriatic disease via telemedicine

“…Telemedicine utilization among dermatologists increased from under 15% to >95% after the pandemic, reflecting its marked popularity among patients and uptake for physicians. 2 , 3 Importantly, this has highlighted that teledermatology can be used beyond the context of a global health crisis to provide continuity of care and improve access to health care more broadly.…”