Impact of teledermatology on the accessibility and efficiency of dermatology care in an urban safety-net hospital: A pre-post analysis.
Adult
Aged
Dermatology
/ methods
Efficiency
Evaluation Studies as Topic
Female
Health Services Accessibility
/ statistics & numerical data
Humans
Male
Middle Aged
Retrospective Studies
Safety-net Providers
/ statistics & numerical data
Skin Diseases
/ diagnosis
Telemedicine
Urban Health Services
/ statistics & numerical data
access
appointments avoided
efficiency
store-and-forward
teledermatology
telehealth
telemedicine
underserved populations
Journal
Journal of the American Academy of Dermatology
ISSN: 1097-6787
Titre abrégé: J Am Acad Dermatol
Pays: United States
ID NLM: 7907132
Informations de publication
Date de publication:
Dec 2019
Dec 2019
Historique:
received:
09
05
2019
revised:
17
07
2019
accepted:
02
08
2019
pubmed:
16
8
2019
medline:
17
4
2020
entrez:
16
8
2019
Statut:
ppublish
Résumé
Teledermatology enables dermatologists to remotely triage and evaluate dermatology patients, but previous studies have questioned whether teledermatology is clinically efficient. To determine whether implementation of a teledermatology system at the Zuckerberg San Francisco General Hospital and Trauma Center has improved the accessibility and efficiency of dermatology care delivery. Retrospective, pre-post analysis of a pre-teledermatology cohort (June 2014-December 2014) compared with a post-teledermatology cohort (June 2017-December 2017). Our analysis captured 11,586 patients. After implementation of teledermatology, waiting times for new patients decreased significantly (84.6 days vs 6.7 days; P < .001), total cases evaluated per month increased significantly (754 vs 901; P = .008), and number of cases evaluated per dermatologist-hour increased significantly (2.27 vs 2.63; P = .010). In the post-teledermatology period, 61.8% of teledermatology consults were managed without a clinic visit. We were unable to control for changes in demand for dermatology evaluations between the 2 periods and did not have a control group with which to compare our results. The dermatology service was more accessible and more efficient after implementation of teledermatology, suggesting that capitated health care settings can benefit from implementation of a teledermatology system.
Sections du résumé
BACKGROUND
BACKGROUND
Teledermatology enables dermatologists to remotely triage and evaluate dermatology patients, but previous studies have questioned whether teledermatology is clinically efficient.
OBJECTIVE
OBJECTIVE
To determine whether implementation of a teledermatology system at the Zuckerberg San Francisco General Hospital and Trauma Center has improved the accessibility and efficiency of dermatology care delivery.
METHODS
METHODS
Retrospective, pre-post analysis of a pre-teledermatology cohort (June 2014-December 2014) compared with a post-teledermatology cohort (June 2017-December 2017).
RESULTS
RESULTS
Our analysis captured 11,586 patients. After implementation of teledermatology, waiting times for new patients decreased significantly (84.6 days vs 6.7 days; P < .001), total cases evaluated per month increased significantly (754 vs 901; P = .008), and number of cases evaluated per dermatologist-hour increased significantly (2.27 vs 2.63; P = .010). In the post-teledermatology period, 61.8% of teledermatology consults were managed without a clinic visit.
LIMITATIONS
CONCLUSIONS
We were unable to control for changes in demand for dermatology evaluations between the 2 periods and did not have a control group with which to compare our results.
CONCLUSION
CONCLUSIONS
The dermatology service was more accessible and more efficient after implementation of teledermatology, suggesting that capitated health care settings can benefit from implementation of a teledermatology system.
Identifiants
pubmed: 31415834
pii: S0190-9622(19)32563-0
doi: 10.1016/j.jaad.2019.08.016
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1446-1452Informations de copyright
Copyright © 2019 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.