Should Your Practice Adopt Teledermatology?
As of 2015, 62% of smartphone owners had used their phone to research a medical condition in the past year, and as one McKinsey report shows, 75% of patients would like to receive digital health care.1,2 Specifically, the report found patients are looking for more efficient care, clearer guidance, and access to a real person, should they have any questions.
Though we generally talk about digital health care in grandiose terms, it does not have to be complex. With the right teledermatology partner, your practice can quickly begin offering established patients (and prospective patients) the virtual care they seek.
Although some providers may think they can avoid the growth of digital care, they would be hard-pressed to do so. Patients’ expectations around care are on the rise, with particular eagerness for value as well as communication and connectivity.3 As one book on the industry put it, “Health care is the largest service sector in many economies worldwide, but it lags behind other industries in the use of efficient and innovative approaches to both patient care and service organization.”4
Teledermatology and Quality of Care
The 2 primary types of teledermatology are store-and-forward (photos and symptoms are submitted and reviewed asynchronously) and live-interactive dermatology (which, as the name suggests, involves a live consultation, much like a video conference). While live-interactive may seem like the more appealing option on the surface, it does not offer tangible improvements over store-and-forward consultations.5 In fact, any still camera will produce higher quality images than video will.
Not only do asynchronous, text- and image-based consultations perform just as well as live-interactive appointments, they can also be as effective as in-person visits.5
One randomized trial found that “store-and-forward teledermatology did not result in a significant difference in clinical course at either of 2 post-referral time periods” compared with conventional consultations.6
Additionally, store-and-forward teledermatology and conventional, clinic-based care offered comparable long-term clinical outcomes.7 These results are supported by numerous studies, which have consistently found concordance between digital and in-person diagnoses.8-10 A key element in the effectiveness of teledermatology is the quality of the photo, and ongoing improvements in smartphone camera quality will result in more effective teledermatology consultations.11
Teledermatology may have an added impact on quality of care in 2 more key ways. It reduces patients’ wait times to see a physician, particularly in areas with fewer doctors, and reduces the cost of care.12-14 Insofar as these factors impact the efficiency and regularity of dermatological visits, it could have profound impacts on overall health outcomes.
“I was initially concerned that patients would opt to connect virtually in lieu of scheduling an office visit but surprisingly instead it has been a tool that allows me to more efficiently triage care and actually open up appointment slots for patients who require procedures,” said Debra Price, MD, in practice in Miami, FL.
As one study focused on cutaneous melanoma found, “teledermatology was shown to be accurate and reliable and able to significantly shorten the waiting periods for consultation with a dermatologist.”12 In one underserved, rural region, telemedicine was found to reduce patient loss due to rationing of physician access by 20%.13
Also, as of 2014, 33% of consumers had put off medical care due to cost, according to a Gallup survey.15 Because teledermatology can reduce the cost of care, it can induce patients to consult with their dermatologist more regularly, yielding better outcomes.16,17 Add to this the enormous rates of medical noncompliance (caused, in part, by a lack of understanding of instructions), and it is clear that making physicians more accessible through teledermatology could significantly improve quality of care.18
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