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Store-and-forward teledermatology cuts time to consults, does not increase healthcare utilization

In a U.S. study of store-and-forward teledermatology, adoption of the system by primary care practitioners reduced the response time for a consultation to under five hours from almost 84 days. Use of this teledermatology system also did not result in any undue increases in healthcare utilization or cost that might be prohibitive to making the practice widespread, the authors note.

Published online ahead of print in Telemedicine and e-Health (Nov. 4, 2020), the study included 167 patients, as well as a retrospective control group of 1,962 patients for comparison who had followed the traditional consultation system of seeing their primary care doctor, receiving a referral, and then scheduling an in-person appointment with a dermatologist.

Five primary care practices participated, training their clinicians to send clinical photographs over a secure application to a rotation of eight dermatologists for consults. This approach was used instead of the usual process of referring patients to the next available in-person dermatology appointment.

Study data was collected between June 2016 and May 2017, prior to the Covid-19-related increase in utilization of telemedicine services.

“Telemedicine offers the opportunity to accelerate health care access by getting around infrastructure barriers: namely, heavily booked dermatology practices,” said the study’s senior author, Dr. Jules Lipoff, in a press release. “Our study provides evidence that more patients can be cared for with the same amount of resources we’re using now.”

Dr. Lipoff is an assistant professor of clinical dermatology at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

“Video-based telemedicine has been extremely helpful amid the social distancing precautions brought about by the Covid-19 outbreak,” Dr. Lipoff said. “But we also need to look toward how we can expand other forms that may be more efficient in delivering care, such as ‘Store-and-Forward,’ since we have shown how effective they can be.”

The authors note in the release that it is unclear whether many of the changes in telemedicine brought about from the Covid-19 expansion will become permanent. However, they hope their study can serve as proof of the viability of photo-based telemedicine for dermatology and other specialties.


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