Supporting Virtual Dermatology Consultation in the Setting of COVID-19

Kutner, Allison; Love, Danielle Bullen; Markova, Alina; Rossi, Anthony; Lee, Erica; Nehal, Kishwer S.; Lacouture, Mario E.; Rotemberg, Veronica

doi:10.1007/s10278-021-00425-6

Cited by 10 publications

(7 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…During the COVID-19 pandemic, the integration of asynchronous teledermatology into inpatient consultations substantially increased as dermatology departments sought to maximize patient safety by minimizing unnecessary clinical exposures [ 35 ]. Consequently, some medical centers developed triage algorithms using SAF images to minimize physical contact [ 35 , 43 , 44 ]. The value of asynchronous teledermatology versus in-person evaluation for inpatient consultation depends on the medical decision in question.…”

Section: Resultsmentioning

confidence: 99%

“…The COVID-19 pandemic necessitated many clinics to temporarily adopt teledermatology for all patient encounters. Although most teledermatology visits were synchronous, asynchronous visits drastically increased from prior years [33][34][35]. For example, one program reported 3 asynchronous visits in April 2019 and 197 asynchronous visits in April 2020, increasing from <1% of all patient encounters to approximately 10% [33,34].…”

Section: Outpatient Managementmentioning

confidence: 99%

See 1 more Smart Citation

Store-and-Forward Images in Teledermatology: Narrative Literature Review

Jiang¹,

Flynn²,

Kwock³

et al. 2022

JMIR Dermatol

View full text Add to dashboard Cite

Background Store-and-forward (SAF) teledermatology uses electronically stored information, including patient photographs and demographic information, for clinical decision-making asynchronous to the patient encounter. The integration of SAF teledermatology into clinical practice has been increasing in recent years, especially during the COVID-19 pandemic. Despite this growth, data regarding the outcomes of SAF teledermatology are limited. A key distinction among current literature involves comparing the quality and utility of images obtained by patients and trained clinicians, as these metrics may vary by the clinical expertise of the photographer. Objective This narrative literature review aimed to characterize the outcomes of SAF teledermatology through the lens of patient- versus clinician-initiated photography and highlight important future directions for and challenges of the field. Methods A literature search of peer-reviewed research was performed between February and April 2021. Key search terms included patient-initiated, patient-submitted, clinician-initiated, clinician-submitted, store-and-forward, asynchronous, remote, image, photograph, and teledermatology. Only studies published after 2001 in English were included. In total, 47 studies were identified from the PubMed electronic database and Google Scholar after omitting duplicate articles. Results Image quality and diagnostic concordance are generally lower and more variable with patient-submitted images, which may impact their decision-making utility. SAF teledermatology can improve the efficiency of and access to care when photographs are taken by either clinicians or patients. The clinical outcomes of clinician-submitted images are comparable to those of in-person visits in the few studies that have investigated these outcomes. Coinciding with the onset of the COVID-19 pandemic, asynchronous teledermatology helped minimize unnecessary in-person visits in the outpatient setting, as many uncomplicated conditions could be adequately managed remotely via images captured by patients and referring clinicians. For the inpatient setting, SAF teledermatology minimized unnecessary contact during dermatology consultations, although current studies are limited by the heterogeneity of their outcomes. Conclusions In general, photographs taken by trained clinicians are higher quality and have better and more relevant diagnostic and clinical outcomes. SAF teledermatology helped clinicians avoid unnecessary physical contact with patients in the outpatient and inpatient settings during the COVID-19 pandemic. Asynchronous teledermatology will likely play a greater role in the future as SAF images become integrated into synchronous teledermatology workflows. However, the obstacles summarized in this review should be addressed before its widespread implementation into clinical practice.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Outpatient Managementmentioning

confidence: 99%

Store-and-Forward Images in Teledermatology: Narrative Literature Review

Jiang¹,

Flynn²,

Kwock³

et al. 2022

JMIR Dermatol

View full text Add to dashboard Cite

show abstract

“…Virtual care in nutrition, nursing, and physical therapy has reduced in-person visits for individuals with chronic illnesses while maintaining clinical standards [16] , [17] . Although virtual care has been catalyzed from the pandemic, one report in the field of dermatology showed that a vast majority of patients will continue to prefer virtual care in a post pandemic world [18] . These comparisons suggest that outside of radiotherapy, virtual care and education is being implemented to a similar high degree of acceptability and feasibility and may warrant continued use as an increasing expectation by patients.…”

Section: Discussionmentioning

confidence: 99%

Virtual integration of patient education in radiotherapy (VIPER)

Magliozzi

Cashell

Ishmail

et al. 2022

Technical Innovations & Patient Support in Radiation Oncolo

View full text Add to dashboard Cite

“…This led to a major effort by all health care stakeholders-regulators, payors, patients, and providers-to implement telemedicine. 5 The goal of this study was to analyze telemedicine adoption and usage patterns by Mohs micrographic surgeons (MMS) before and during the initial surges of COVID-19, as well as the attitudes and perceived barriers to its long-term postpandemic continuation by MMS practices.…”

mentioning

confidence: 99%

“…This led to a major effort by all health care stakeholders—regulators, payors, patients, and providers—to implement telemedicine. 5…”

mentioning

confidence: 99%

Pilot Survey of Adoption of Telemedicine in Mohs Surgery During the COVID-19 Pandemic

et al. 2021

Self Cite

View full text Add to dashboard Cite

BACKGROUND The Covid-19 Pandemic prompted the widespread implementation of telemedicine across healthcare. OBJECTIVE To analyze telemedicine adoption by Mohs Micrographic surgeons (MMS) during the COVID-19 pandemic; to analyze the attitudes and perceived barriers to its long-term continuation by MMS practices. METHODS AND MATERIALS An online multiple-choice survey was distributed to members of the American College of Mohs Surgeons. RESULTS 86.1% of surveyed Mohs surgeons initiated telemedicine during the pandemic surge. The most common uses for telemedicine amongst respondents were post-surgery management (77.4%), "spot checks" (60.9%), and surgical consultations (59.1%). 73.1% report patients were receptive to telemedicine. 68.6% believe that telemedicine has a place in dermatologic surgery; 49.5% plan to incorporate telemedicine into their surgical practices long-term. Physical exam limitations, fitting telemedicine into practice workflow, and patient reception/patient training were viewed as the most significant barriers to long-term implementation. CONCLUSIONS While valuable use cases for telemedicine were identified with most Mohs surgeon respondents feeling that telemedicine has a place in their practices, there is uncertainty in how to implement telemedicine into the dermatologic surgery practice workflow.T elemedicine has been a promising technology with the potential to expand and improve health care delivery. However, widespread adoption in both primary care and specialty medicine has been slow. A 2016 study found that only 42% of hospitals and 15% of family physicians had adopted telemedicine in any form. 1 Major historical barriers to telemedicine adoption were lack of payer reimbursement and requirements for special licensure to treat patients across state lines. 2,3 As is often the case with implementation of new health care technology, the necessary legislative and regulatory updates required to bring telemedicine to the forefront were slow to be adopted. 4 In March 2020, one of the first of many stay-at-home orders across the United States was enacted to slow the spread of the surging COVID-19 viral pandemic. As such many medical practices had to shut down, and the adoption of telemedicine became not just a promising option, but a necessity for many patients. This led to a major effort by all health care stakeholders-regulators, payors, patients, and providers-to implement telemedicine. 5 The goal of this study was to analyze telemedicine adoption and usage patterns by Mohs micrographic surgeons (MMS) before and during the initial surges of COVID-19, as well as the attitudes and perceived barriers to its long-term postpandemic continuation by MMS practices. MethodsAfter institutional review board approval, a 23-question multiple choice survey was approved and distributed by the American College of Mohs Surgery (ACMS) in September 2020 through a monthly bulletin-board email. During the month of October 2020, we sent an additional email to 500 ACMS members based on their geographic distribution with...

show abstract

Supporting Virtual Dermatology Consultation in the Setting of COVID-19

Cited by 10 publications

References 14 publications

Store-and-Forward Images in Teledermatology: Narrative Literature Review

Store-and-Forward Images in Teledermatology: Narrative Literature Review

Virtual integration of patient education in radiotherapy (VIPER)

Pilot Survey of Adoption of Telemedicine in Mohs Surgery During the COVID-19 Pandemic

Contact Info

Product

Resources

About