Teledermatology: Comparison of Store-and-Forward Versus Live Interactive Video Conferencing

Abstract

A decreasing number of dermatologists and an increasing number of patients in Western countries have led to a relative lack of clinicians providing expert dermatologic care. This, in turn, has prolonged wait times for patients to be examined, putting them at risk. Store-and-forward teledermatology improves patient access to dermatologists through asynchronous consultations, reducing wait times to obtain a consultation. However, live video conferencing as a synchronous service is also frequently used by practitioners because it allows immediate interaction between patient and physician. This raises the question of which of the two approaches is superior in terms of quality of care and convenience. There are pros and cons for each in terms of technical requirements and features. This viewpoint compares the two techniques based on a literature review and a clinical perspective to help dermatologists assess the value of teledermatology and determine which techniques would be valuable in their practice.

Externe wissenschaftliche Evaluation der ersten Teledermatologie-App ohne direkten Patientenkontakt in Deutschland („Online Hautarzt – AppDoc“)

“…Im Rahmen der aus der Pandemie mit SARS-CoV-2 resultierenden Regelung ist es nun auch möglich, die Videosprechstunde einzusetzen, wenn ein Patient vorher noch nicht in der Praxis war [10]. Hierbei handelt es sich definitiv um signifikante Fortschritte in der Anwendbarkeit der Telemedizin, jedoch muss einschränkend erwähnt werden, dass die Technologie der Videotelefonie die Arbeitslast von Ärztinnen und Ärzten potenziell eher erhöht als vermindert, möglicherweise sogar kostenintensiver ist und einer schnellen Internetverbindung bedarf, die in ländlichen Regionen keine Selbstverständlichkeit darstellt [6,14].…”

“…Die Store-and-Forward-Teledermatologie bietet verschiedene Vorteile gegenüber der Live-Videodermatologie. So ist beispielsweise weder eine schnelle Internetverbindung noch eine Terminvereinbarung zwischen Arzt und Patient erforderlich [6].…”

Utilization of Asynchronous and Synchronous Teledermatology in a Large Health Care System During the COVID-19 Pandemic

“…5 Asynchronous visits use store-and-forward technologies such as secure text, e-mail, or direct-to-physician electronic medical records. [6][7][8] Synchronous visits are performed using live, real-time, and collaborative telecommunications technology (audio and/or video) between the provider and the patient. 7,8 Hybridization is the use of asynchronous and synchronous modalities simultaneously.…”

“…[6][7][8] Synchronous visits are performed using live, real-time, and collaborative telecommunications technology (audio and/or video) between the provider and the patient. 7,8 Hybridization is the use of asynchronous and synchronous modalities simultaneously. 5 Both technologies provide significant advantages: asynchronous visits have lower costs and flexible timing, whereas synchronous visits allow immediate interactions between patient and physician.…”

“…5 Both technologies provide significant advantages: asynchronous visits have lower costs and flexible timing, whereas synchronous visits allow immediate interactions between patient and physician. 7 Yet, both systems also have disadvantages such as privacy concerns, technological difficulties, and a lack of communication for asynchronous visits. 2,6 Limited data exist comparing the technologies and, as such, a consensus on patient and provider preference has not yet been reached.…”