Teledermatology: An updated overview of clinical applications and reimbursement policies☆☆☆

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Abstract

Telemedicine is an emerging field in healthcare that provides services from different medical specialties to patients all around the world. One of the specialties in telemedicine, teledermatology, has grown exponentially as a cost-effective way to implement dermatological healthcare to underserved areas and populations. This article reviews the literature that pertains to the cost-effectiveness, reliability, public access, patient satisfaction, and reimbursement policies of teledermatology. Teledermatology was found to be cost-effective and reliable in reducing in-person visits and time away from work, and allows for the faster delivery of care. However, reimbursement policies for teledermatology services are rather new and vary significantly from state to state. As public interest in and access to teledermatology continue to grow, the future of teledermatology depends on the development of new technology as well as quality improvement strategies and the evolution of sustainable reimbursement policies.

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Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems

E. Tensen, J. P. van der Heijden, M. Jaspers … (2016)

Teledermatology, originating in 1995, has been one of the first telemedicine services to see the light of day. Two decades of teledermatology research is summarized in this review. A literature search was conducted in PubMed. Search terms included “teledermatology,” “teledermoscopy,” “tele wound care,” “telederm*,” “(dermatology OR dermoscopy OR wound care OR skin) AND (telemedicine OR ehealth or mhealth OR telecare OR teledermatology OR teledermoscopy).” Inclusion criteria were (i) Dutch or English written papers and (ii) publication year from 2011 to present or (iii) (systematic) reviews with publication year before 2011. One hundred fourteen publications and 14 (systematic) reviews were included for full text reading. Focus of this review is on the following outcomes: (i) actors (primary, secondary, tertiary), (ii) purposes (consultation, triage, follow-up, education) and subspecialties (tele-wound care, burn care, teledermoscopy (teledermatoscopy), teledermatopathology, and mobile teledermatology), (iii) delivery modalities and technologies (store and forward, real-time interactive, and hybrid modalities using web-based systems, email, mobile phones, tablets, or videoconferencing equipment), (iv) business models, (v) integration of teledermatology into national healthcare systems, (vi) preconditions and requirements for implementation (security, ethical issues, responsibility, reimbursement, user satisfaction, technique, and technology standards), and (vii) added value. To conclude, teledermatology is an efficient and effective healthcare service compared to in-person care. Teledermatology reduces patients’ travel time and waiting time, avoids (unnecessary) dermatologic visits, and improves access of care to underserved patients.

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Teledermatology: from historical perspective to emerging techniques of the modern era: part I: History, rationale, and current practice.

Sarah Coates, Joseph Kvedar, Richard D Granstein (2015)

Telemedicine is the use of telecommunications technology to support health care at a distance. Technological advances have progressively increased the ability of clinicians to care for diverse patient populations in need of skin expertise. Dermatology relies on visual cues that are easily captured by imaging technologies, making it ideally suited for this care model. Moreover, there is a shortage of medical dermatologists in the United States, where skin disorders account for 1 in 8 primary care visits and specialists tend to congregate in urban areas. Even in regions where dermatologic expertise is readily accessible, teledermatology may serve as an alternative that streamlines health care delivery by triaging chief complaints and reducing unnecessary in-person visits. In addition, many patients in the developing world have no access to dermatologic expertise, rendering it possible for teledermatologists to make a significant contribution to patient health outcomes. Teledermatology also affords educational benefits to primary care providers and dermatologists, and enables patients to play a more active role in the health care process by promoting direct communication with dermatologists.

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Teledermatology: key factors associated with reducing face-to-face dermatology visits.

Shoshana Landow, Ashley Mateus, Kaveri Korgavkar … (2014)

Teledermatology makes 3 promises: better, cheaper, and faster dermatologic care. It is "better" because, although it cannot offer as much to the patient as a traditional visit, it extends the dermatologist's reach to places and in ways not previously possible as a result of time and place limitations; it is "cheaper and faster" because it has the potential to reduce costs and increase efficiency for both patients and providers. For teledermatology to fulfill these promises, it must enable dermatologists to improve access by increasing the number of patients evaluated and treated. Increased patient access depends on maximizing a scarce resource-dermatologists' time-in part by avoiding unnecessary and time-consuming face-to-face appointments. We examined the literature to date to determine which teledermatology programs have greater or lesser success in reducing face-to-face visits. Our review highlights 4 factors that are associated with a higher number of face-to-face appointments avoided by teledermatology programs: (1) effective preselection of patients for teleconsultation, (2) high-quality photographic images, (3) dermoscopy if pigmented lesions are evaluated, and (4) effective infrastructure and culture in place to implement teleconsultation recommendations.

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Author and article information

Contributors

J. Lu

Journal

Journal ID (nlm-ta): Int J Womens Dermatol

Journal ID (iso-abbrev): Int J Womens Dermatol

Title: International Journal of Women's Dermatology

Publisher: Elsevier

ISSN (Electronic): 2352-6475

Publication date PMC-release: 20 May 2017

Publication date Collection: September 2017

Publication date (Electronic): 20 May 2017

Volume: 3

Issue: 3

Pages: 176-179

Affiliations

[a ]Department of Internal Medicine, University of Connecticut, Farmington, CT

[b ]School of Medicine, University of Connecticut, Farmington, CT

[c ]Department of Dermatology, University of Connecticut, Farmington, CT

Author notes

[* ]Corresponding Author. jlu@ 123456uchc.edu

Article

Publisher ID: S2352-6475(17)30043-6

DOI: 10.1016/j.ijwd.2017.04.002

PMC ID: 5555283

PubMed ID: 28831431

SO-VID: e7ee8ea3-07a9-47b6-8fb0-35f90b97221b

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

History

Date received : 8 December 2016

Date revision received : 23 April 2017

Date accepted : 23 April 2017

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Teledermatology: An updated overview of clinical applications and reimbursement policies ^☆ ^☆☆

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Most cited references 21

Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems

Teledermatology: from historical perspective to emerging techniques of the modern era: part I: History, rationale, and current practice.

Teledermatology: key factors associated with reducing face-to-face dermatology visits.

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Teledermatology: An updated overview of clinical applications and reimbursement policies ☆ ☆☆

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Special issue: The EU, the Energy Charter Treaty, and sustainability policies: the legal intricacies of trying to boil the ocean

Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems

Teledermatology: from historical perspective to emerging techniques of the modern era: part I: History, rationale, and current practice.

Teledermatology: key factors associated with reducing face-to-face dermatology visits.

Contributors

Journal

Affiliations

Author notes

Article

History

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Teledermatology: An updated overview of clinical applications and reimbursement policies ^☆ ^☆☆