Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease. Academic Article uri icon

Overview

abstract

  • BACKGROUND: Patient outcomes are improved when dermatologists provide inpatient consultations. Inpatient access to dermatologists is limited, illustrating an opportunity to use teledermatology. Little is known about the ability of dermatologists to accurately diagnose disease and manage inpatients with teledermatology, particularly when using nondermatologist-generated clinical data. METHODS: This prospective study assessed the ability of teledermatology to diagnose disease and manage 41 dermatology consultations from a large urban tertiary care center, using internal medicine referral documentation and photographs. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the κ statistic. RESULTS: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median κ = 0.83), substantial agreement in laboratory evaluation decisions (median κ = 0.67), almost perfect agreement in imaging decisions (median κ = 1.0), and moderate agreement in biopsy decisions (median κ = 0.43). There was almost perfect agreement in treatment (median κ = 1.0), but no agreement in follow-up planning (median κ = 0.0). There was no association between raw photograph quality and the primary plus differential diagnosis or primary diagnosis alone. LIMITATIONS: Selection bias and single-center nature. CONCLUSIONS: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions.

authors

publication date

  • May 7, 2020

Research

keywords

  • Dermatology
  • Hospitalization
  • Remote Consultation
  • Skin Diseases

Identity

PubMed Central ID

  • PMC7204758

Scopus Document Identifier

  • 85096405967

Digital Object Identifier (DOI)

  • 10.1016/j.jaad.2020.04.171

PubMed ID

  • 32389716

Additional Document Info

volume

  • 84

issue

  • 6