November 04, 2016
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Dermatologists, using the latest technology known as Telemedicine, have determined that interactive consultations can improve clinical outcomes for patients because they usually involve beneficial changes in medical diagnosis and disease management that otherwise might not occur. Telemedicine for dermatology patients is a great tool because skin conditions can be readily examined in digital still images. The differences in diagnosis, disease management and clinical outcomes, found that patient care was usually enhanced by specialty consultations via telemedicine. It enables us to bridge the big care gap for those people who don't have easy or convenient access to a dermatologist. Telemedicine is experiencing increased use in geographically distant regions and other medically underserved communities. Telemedicine in dermatology includes image files that are saved and forwarded to a dermatologist for review (known as "store-and-forward") at any time. These interactive sessions have the advantage of allowing instant clarification about a patient's health history as well as allowing a specialist to immediately capture additional digital images if more clinical information is needed. This interactive technology is nearly equivalent to physically being in the room with a patient. It enables dermatologists to see the skin problems, and have real-time discussions with patients and their providers as if we were in the room together and if an appointment is needed they can schedule at that time. Studies confirm that this is an effective tool to improve patient outcomes. A retrospective analysis of medical records was conducted for 1,500 patients who were evaluated using live interactive teledermatology. Patients with two or more teledermatology visits within a one-year period were assessed for changes in clinical outcomes. Compared with diagnoses and treatment plans from the referring physician alone, the 1,500 teledermatology consultations resulted in diagnostic changes for nearly 70 percent of patients. Those changes in diagnoses included identifying benign lesions where malignant ones had been diagnosed by a primary-care provider, and diagnosing a malignancy for diseases such as basal cell carcinoma after an initial, primary-care diagnosis of benign cell growth. The consultations also resulted in nearly every single patient (97.7 percent) receiving recommendations via teledermatology to change the way patients managed their skin diseases. Those changes included dermatologist recommendations to begin or end a medication, to modify the dosage or delivery of a medication, and to undergo additional laboratory tests or cultures. It was determined that the live consultations likely resulted in improved diagnostic accuracy and more effective treatment plans. Patients receiving a changed diagnosis had better chances of clinical improvements compared to patients whose diagnoses remained unchanged. Each additional teledermatology follow-up visit was associated with better odds of improved clinical outcomes. With rapid improvements in interactive mobile platforms, connectivity speed and visual clarity, telehealth services like dermatology will play a bigger and bigger role in improving the quality of care and the access to specialty services that people deserve no matter where they live.