Telemedicine could improve treatment of skin disease
MedWire News: Patients with skin conditions could benefit from having virtual consultations with a dermatologist using live telemedicine, according to a report by US experts.
Writing in the Archives of Dermatology, they say that patients treated via "teledermatology" typically benefited from better diagnosis and treatment as compared with treatment by a primary care doctor.
"Our study showed that live interactive teledermatology consultations resulted in changes in diagnosis and disease management in most consultations," the authors write.
"With advancements in videoconferencing technology, interactive mobile platforms, and connectivity speed, the practice of live interactive teledermatology will likely become more efficient and similar to in-person encounters in the near future."
The research was undertaken by Dr April Armstrong (University of California, Davis, USA) and co-workers, who analyzed the medical records of 1500 patients who were evaluated using live interactive teledermatology.
"Telemedicine is an evolving field that uses technology-enabled health care delivery models to provide patient care from a distance," the authors explain in background information in their article.
For each patient, the researchers compared the opinions of the referring physician (typically a primary care clinician) on diagnosis and treatment with that of the teledermatologist.
They found that, in seven out of ten patients, the teledermatologist's diagnosis differed from that of the referring physician. The three most frequent changes were from an original diagnosis of skin infection to one of psoriasis or eczema; from malignant skin cancer to benign skin lesions; and from a benign skin lesion to a malignant lesion.
Furthermore, in 98% of cases, the teledermatologist recommended making changes to how the patient should be managed. Examples of changes included starting a new medication, stopping an existing medication, changing the dose or delivery of an existing medicine, ordering extra laboratory tests or investigations, and proposing that the patient be observed or given extra information or education.
Importantly, patients whose diagnosis or treatment was altered following the teleconsultation were twice more likely to report an improvement in their symptoms than were patients whose diagnosis or treatment was unchanged. Some patients had several teleconsultations, and the greater the number of teleconsultations the more likely was the patient to get better.
Dr Armstrong and co-workers conclude that live interactive teledermatology visits are associated with improved patient results. "The increasing use of teledermatology to serve geographically distant communities, medically underserved communities, and veterans attests to the continued growth of teledermatology applications in the United States as well as other countries," they write.
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By Joanna Lyford