Telemedicine Effectiveness: Teledermatology is as Reliable and Efficient as In-Person Consultation

A study by the University of Pennsylvania scientists shows that diagnoses of inpatient dermatologists and teledermatologists match completely 82% of the time and partially match 88% of the time.

A study by researchers in the Perelman School of Medicine at the University of Pennsylvania confirms the effectiveness of telemedicine, helping to increase the standard of healthcare provided.  

With the advances of health information technology, using a smartphone healthcare app, allows remote consultations from dermatologists which are reliable at diagnosing and recommending care options for hospitalized patients with skin conditions.

The study, published in the journal JAMA Dermatology, also concludes that teledermatology, using the smartphone healthcare app, is a valuable mechanism for triaging inpatient consultations.

Controlling inpatient consultations through teledermatology helps clinicians deliver healthcare more efficiently in busy hospitals and community hospital settings.

The telemedicine study criteria

For the study, the researchers analyzed 50 adult patients, hospitalized for various skin conditions and in need of inpatient dermatologist consultation, at the Hospital of the University of Pennsylvania.

These patients were evaluated first by an in-person dermatologist and then by two independent teledermatologists via the smartphone healthcare app.

All consultations by teledermatologists were conducted in a standardized format using a secure “store-and-forward” teledermatology smartphone healthcare app.

“Store-and-forward” refers to a telecommunications technique of storing information at an intermediate station for some time and then forwarding it to the final destination or another intermediate station.

Results from the telemedicine study

From the telemedicine study the scienists compared the following:

• The initial triage - the process of determining the priority of patients' treatments based on the severity of their condition and the likely benefit from immediate medical treatment
• Biopsy recommendation (a medical test that involves sampling of cells or tissue for examination) decisions made by the inpatient dermatologist and the teledermatologists.

When the inpatient dermatologist recommended a patient be seen the same day, the teledermatologists independently agreed with the same course of action in 90% of the consultations.

When the inpatient dermatologist recommended a biopsy, the teledermatologists agreed with the decision in 95% of the consultations.

Overall, the teledermatologists agreed fully on diagnoses made by the inpatient dermatologist 82% of the time and agreed partially in 88% of the time.

The differences are in line with the standard variation observed between two different inpatient dermatologists.

Even when the teledermatologists did not choose the same course of action as their inpatient dermatologist, there is a substantial diagnostic agreement between both the counterparts.

The study concludes that teledermatology consultations are reliable and effective in distinguishing cases in need of an urgent consultation and prioritizing follow-up care for both patients and physicians.

The future of telemedicine

The University of Pennsylvania team is also leading the efforts to connect doctors around the world using a smartphone healthcare app – including those from Uganda, Botswana, Malawi, Swaziland, Burkina Faso, and Lesotho.

Using telemedicine solutions allows them to provide dermatology support to local physicians, dermatologists, and health care workers in hospitals and clinics throughout Africa.

If smartphone healthcare app projects can be scaled up successfully, then the problem of shortage and uneven distribution of dermatologists in hospitals at national as well as international levels can be handled effectively using teledermatology solutionss.