Teledermatology: A Review and Update

Telemedicine is slowly transforming the way in which healthcare is delivered and has the potential to improve access to subspecialty expertise, reduce healthcare costs, and improve the overall quality of care. While many subspecialty fields within medicine today have either experimented with or begun to implement telemedicine platforms to enable remote consultation and care, dermatology is particularly suited for this care system as skin disorders are uniquely visible to the human eye. Through teledermatology, diagnostic images of skin disorders with accompanying clinical histories can be remotely reviewed by teledermatologists by any number of modalities, such as photographic clinical images or live video teleconferencing. Diagnoses and treatment recommendations can then be rendered and implemented remotely. The evidence to date supports both its diagnostic and treatment accuracy and its cost effectiveness. Administrative, regulatory, privacy, and reimbursement policies surrounding this dynamic field continue to evolve. In this review, we examine the history, evidence, and administrative landscape surrounding teledermatology and discuss current practice guidelines and ongoing controversies.

[1]  J. Whited,et al.  Cost minimization analysis of a store-and-forward teledermatology consult system. , 2009, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[2]  D. Moreno-Ramírez,et al.  Economic evaluation of a store-and-forward teledermatology system for skin cancer patients , 2009, Journal of telemedicine and telecare.

[3]  F G Mullick,et al.  Telemedicine and telepathology at the Armed Forces Institute of Pathology: history and current mission. , 1996, Telemedicine journal : the official journal of the American Telemedicine Association.

[4]  James H Thrall,et al.  Teleradiology. Part II. Limitations, risks, and opportunities. , 2007, Radiology.

[5]  N F de Keizer,et al.  Teledermatology applied following patient selection by general practitioners in daily practice improves efficiency and quality of care at lower cost , 2011, The British journal of dermatology.

[6]  D. Eedy,et al.  A comparison of real‐time and store‐and‐forward teledermatology: a cost–benefit study , 2000, The British journal of dermatology.

[7]  H. Soyer,et al.  Cost-effectiveness of Store-and-Forward Teledermatology: A Systematic Review. , 2016, JAMA dermatology.

[8]  R. Hofmann-Wellenhof,et al.  Concordance and time estimation of store-and-forward mobile teledermatology compared to classical face-to-face consultation. , 2015, Acta dermato-venereologica.

[9]  J. Cohen,et al.  The Department of Defense: pioneers of early teledermatology. , 2017, Dermatology online journal.

[10]  J. Wolf,et al.  Diagnostic inaccuracy of smartphone applications for melanoma detection. , 2013, JAMA dermatology.

[11]  J. Dover,et al.  The substitution of digital images for dermatologic physical examination. , 1997, Archives of dermatology.

[12]  D. Brousseau,et al.  Store-and-forward teledermatology versus in-person visits: a comparison in pediatric teledermatology clinic. , 2009, Journal of the American Academy of Dermatology.

[13]  D. Moreno-Ramírez,et al.  A 10-Year History of Teledermatology for Skin Cancer Management. , 2015, JAMA dermatology.

[14]  R. Porter,et al.  Patient's Progress: Doctors and Doctoring in Eighteenth-Century England , 1989 .

[15]  R. Poropatich,et al.  Web-based teledermatology consult system: preliminary results from the first 100 cases. , 1999, Studies in health technology and informatics.

[16]  J. Whited,et al.  Reliability and accuracy of dermatologists' clinic-based and digital image consultations. , 1999, Journal of the American Academy of Dermatology.

[17]  Steven C Grambow,et al.  Teledermatology's impact on time to intervention among referrals to a dermatology consult service. , 2002, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[18]  J. Kvedar,et al.  Teledermatology: from historical perspective to emerging techniques of the modern era: part I: History, rationale, and current practice. , 2015, Journal of the American Academy of Dermatology.

[19]  R. Dellavalle,et al.  Mobile applications in dermatology. , 2013, JAMA dermatology.

[20]  H. Lamminen,et al.  A feasibility study of realtime teledermatology in Finland , 2000, Journal of telemedicine and telecare.

[21]  R A Sheehan-Dare,et al.  An evaluation of the role of a store‐and‐forward teledermatology system in skin cancer diagnosis and management , 2005, Clinical and experimental dermatology.

[22]  Nicolette F de Keizer,et al.  A cost minimisation analysis in teledermatology: model-based approach , 2010, BMC health services research.

[23]  L. Drage,et al.  Assessment of the accuracy of low-cost store-and-forward teledermatology consultation. , 2000, Journal of the American Academy of Dermatology.

[24]  J. M. Ríos-Yuil,et al.  [Correlation between face-to-face assessment and telemedicine for the diagnosis of skin disease in case conferences]. , 2012 .

[25]  D. Moreno-Ramírez,et al.  Teledermatología prequirúrgica en pacientes con cáncer cutáneo no melanoma. Evaluación económica , 2008 .

[26]  H. Chan,et al.  Teledermatology in Hong Kong: a cost‐effective method to provide service to the elderly patients living in institutions , 2000, International journal of dermatology.

[27]  R. Poropatich,et al.  Teledermatology: an intraobserver diagnostic correlation study, part I. , 2003, Cutis.

[28]  Francisco J. Narbona,et al.  Internet‐based skin cancer screening using clinical images alone or in conjunction with dermoscopic images: A randomized teledermoscopy trial , 2017, Journal of the American Academy of Dermatology.

[29]  Kambiz Bahaadinbeigy,et al.  Estimating travel reduction associated with the use of telemedicine by patients and healthcare professionals: proposal for quantitative synthesis in a systematic review , 2011, BMC health services research.

[30]  C Massone,et al.  The additive value of second opinion teleconsulting in the management of patients with challenging inflammatory, neoplastic skin diseases: a best practice model in dermatology? , 2007, Journal of the European Academy of Dermatology and Venereology : JEADV.

[31]  C. Nelson,et al.  The reliability of teledermatology to triage inpatient dermatology consultations. , 2014, JAMA dermatology.

[32]  D. Vidmar,et al.  The history of teledermatology in the Department of Defense. , 1999, Dermatologic clinics.

[33]  Perednia Da,et al.  Teledermatology: one application of telemedicine. , 1995 .

[34]  The impact of store-and-forward teledermatology on skin cancer diagnosis and treatment. , 2008, Journal of the American Academy of Dermatology.

[35]  T. Bergmo,et al.  A cost-minimization analysis of a realtime teledermatology service in northern Norway , 2000, Journal of telemedicine and telecare.

[36]  B. Zelickson,et al.  Teledermatology in the nursing home. , 1997, Archives of dermatology.

[37]  J. Resneck,et al.  Choice, Transparency, Coordination, and Quality Among Direct-to-Consumer Telemedicine Websites and Apps Treating Skin Disease. , 2016, JAMA dermatology.

[38]  David B Nelson,et al.  Reliability of store and forward teledermatology for skin neoplasms. , 2015, Journal of the American Academy of Dermatology.

[39]  Harold S Rabinovitz,et al.  Accuracy of teledermatology for nonpigmented neoplasms. , 2009, Journal of the American Academy of Dermatology.

[40]  Harold S Rabinovitz,et al.  Accuracy of teledermatology for pigmented neoplasms. , 2009, Journal of the American Academy of Dermatology.

[41]  D. Moreno-Ramírez,et al.  Teledermatology‐Based Presurgical Management for Nonmelanoma Skin Cancer: A Pilot Study , 2007, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[42]  R. Wootton,et al.  Community photo‐triage for skin cancer referrals: an aid to service delivery , 2011, Clinical and experimental dermatology.

[43]  E. Hanada,et al.  Usefulness and economic evaluation of ADSL‐based live interactive teledermatology in areas with shortage of dermatologists , 2010, International journal of dermatology.

[44]  R. Hofmann-Wellenhof,et al.  Geriatric teledermatology: store‐and‐forward vs. face‐to‐face examination , 2011, Journal of the European Academy of Dermatology and Venereology : JEADV.

[45]  J. Whited,et al.  A pilot trial of digital imaging in skin cancer , 1998, Journal of telemedicine and telecare.

[46]  Thomas E. Moritz,et al.  Cost and Utility Analysis of a Store-and-Forward Teledermatology Referral System: A Randomized Clinical Trial. , 2015, JAMA dermatology.

[47]  Lanis L Hicks,et al.  Diagnosis, diagnostic confidence, and management concordance in live-interactive and store-and-forward teledermatology compared to in-person examination. , 2008, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[48]  Michael Shapiro,et al.  Comparison of skin biopsy triage decisions in 49 patients with pigmented lesions and skin neoplasms: store-and-forward teledermatology vs face-to-face dermatology. , 2004, Archives of dermatology.

[49]  S. G. Brown A telephone relay , 1910 .

[50]  G. Romero,et al.  Randomized controlled trial comparing store‐and‐forward teledermatology alone and in combination with web‐camera videoconferencing , 2010, Clinical and experimental dermatology.

[51]  M Rademaker,et al.  A cost-minimization analysis of the societal costs of realtime teledermatology compared with conventional care: results from a randomized controlled trial in New Zealand , 2001, Journal of telemedicine and telecare.

[52]  D. Oh,et al.  Practice Guidelines for Teledermatology. , 2016, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[53]  J. Emery,et al.  Smartphone applications for melanoma detection by community, patient and generalist clinician users: a review , 2015, British Journal of Dermatology.

[54]  L. Machet [Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: societal cost-benefit analysis]. , 2002, Annales de dermatologie et de venereologie.

[55]  A. Oakley,et al.  Better, sooner, more convenient: A successful teledermoscopy service , 2012, The Australasian journal of dermatology.

[56]  Correlación del Teleateneo con el Ateneo presencial de Dermatología en el diagnóstico de las patologías cutáneas , 2012 .

[57]  A. Armstrong,et al.  Economic evaluation of interactive teledermatology compared with conventional care. , 2007, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[58]  A. Armstrong,et al.  Impact of live interactive teledermatology on diagnosis, disease management, and clinical outcomes. , 2012, Archives of dermatology.

[59]  A. Armstrong,et al.  Cost-effectiveness analysis of a patient-centered care model for management of psoriasis. , 2012, Journal of the American Academy of Dermatology.

[60]  James H Thrall,et al.  Teleradiology. Part I. History and clinical applications. , 2007, Radiology.

[61]  Griffiths,et al.  Comparison of teleconsultations and face‐to‐face consultations: preliminary results of a United Kingdom multicentre teledermatology study , 1998, The British journal of dermatology.

[62]  Lansing G. Ellsworth,et al.  Diagnostic accuracy and image quality using a digital camera for teledermatology. , 1999, Telemedicine journal : the official journal of the American Telemedicine Association.

[63]  A. Lim,et al.  Accuracy and reliability of store‐and‐forward teledermatology: Preliminary results from the St George Teledermatology Project , 2001, The Australasian journal of dermatology.

[64]  Hadley Wickham,et al.  Diagnostic value of written referral and/or images for skin lesions , 2006, Journal of telemedicine and telecare.

[65]  Carrie L Kovarik,et al.  Application of mobile teledermatology for skin cancer screening. , 2012, Journal of the American Academy of Dermatology.

[66]  D. Moreno-Ramírez,et al.  [An economic analysis of presurgical teledermatology in patients with nonmelanoma skin cancer]. , 2008, Actas dermo-sifiliograficas.

[67]  J W Burnett,et al.  Teledermatology and in-person examinations: a comparison of patient and physician perceptions and diagnostic agreement. , 1998, Archives of dermatology.

[68]  D. Moreno-Ramírez,et al.  Teledermatology as a filtering system in pigmented lesion clinics. , 2005, Journal of telemedicine and telecare.

[69]  D. Eedy,et al.  A randomized controlled trial to assess the clinical effectiveness of both realtime and store-and-forward teledermatology compared with conventional care , 2000, Journal of telemedicine and telecare.