Teledermatology
Teledermatology is a subspecialty in the medical field of
The dermatologists Perednia and Brown were the first to coin the term "teledermatology" in 1995. In a scientific publication, they described the value of a teledermatologic service in a rural area underserved by dermatologists.[5]
Modes of data transmission
Teledermatology (as telemedicine) is practised on the basis of two concepts: Store and forward (SAF) and real time/live interactive teledermatology. Hybrid modes also exist (combining SAF and real time applications).
The SAF method is most commonly used in teledermatology: It involves sending (forwarding) digital images associated with (anonymous) medical information to the data storage unit of a consulted specialist. It can be as easy as sending an email with a digital image of a lesion to seek advice for a skin condition. Advantages of this method are that it does not demand the presence of both parties at the same time and does not usually require expensive equipment.
In real-time/ live interactive teledermatology applications, provider and individuals usually interact via live
Areas of application
Health care management
There is insufficient evidence to support teledermatology in diagnosing and triaging patients for specialist care. Therefore, more studies are needed to determine its effectiveness.[6]
Direct consultation involves an individual with a skin condition contacting a dermatologist via telecommunication to request diagnosis and treatment. In this field, mobile applications of teledermatology gain importance.
Specialist referral is a major area of application in teledermatology A general practitioner (or other medical professional) that sees the individual consults a specialist/ specialised centre via telecommunication to get a second opinion. The specialist then helps the GP in rendering a diagnosis, providing management options et cetera.[7]
Home telehealth/telehomecare involves an individual with a chronic condition being examined and managed remotely at home. An important field of interest of telehomecare in dermatology is the follow-up treatment of individuals with skin conditions requiring regular follow-up such as crural ulcers or psoriasis management. Crural ulcers are a common skin condition that needs follow up visits up to twice a week demanding significant time commitments by the individuals in addition to causing a financial burden on the health care system.[8] Psoriasis is experienced by 3.2% of adults in the United States, and emerging research on teledermatology treatment of this condition suggests increased access to specialty care with positive patient satisfaction, outcomes, and cost savings.[9]
Education and information
Medical education/continuous education are a major advantage of telemedicine/e-health. Numerous universities offer online courses, computer-based training and Web applications in this field principally aimed at medical students. Specialist training courses via internet are also available, particularly in
General medical/health information may be accessed by non-professionals, such as individuals affected by a skin condition, and their relatives, through the internet. They are also able to join peer support groups with others affected by the same condition.[11]
Domains with special interest
Teledermoscopy
In teledermoscopy, digital dermoscopic lesion images (with or without clinical images) are transmitted electronically to a specialist for examination. This can be done on the web-based telediagnostic network Campus Medicus.
Teledermatopathology
Teledermatopathology is the transmission of dermatopathologic images either in real-time with the aid of a robotic microscope or using a store-and-forward system (transmission as a single file). In the latter method (SAF) a rather new development is the introduction of virtual slide systems (VSS).[12]
Virtual slides are made by digitally scanning an entire glass slide at a high
Teledermoscopically aided dermatopathology
This is the transmission of crucial medical data and dermoscopic as well as clinical images to a pathologist who renders the conventional histopathologic diagnosis.
In the everyday clinical setting, skin
Additionally it has been shown that provision of such data may improve the level of diagnostic confidence held by the assessing dermatopathologists.
Mobile teledermatology
Mobile telemedicine is a system in which at least one participant (the person seeking advice or the doctor, for instance) uses wireless or mobile equipment
Suitability of cases
Not all cases are suitable for teledermatology. The type of cases suited for teledermatology is a topic, which requires more studies. Some studies have observed that eczema and follicular lesions were diagnosed with relatively more certainty, while in some other studies it was seen that diagnoses were made with more certainty in cases like viral warts, herpes zoster, acne vulgaris, irritant dermatitis, vitiligo, and superficial bacterial and fungal infections. Unlike in western studies where pigmented lesions suspicious of melanomas are one of the most referred cases for teledermatology (with or without teledermatoscopy), Asian studies have fewer cases referred based on the suspicion of melanoma.[17]
Implemented projects by country
United Kingdom
24% of the population in England and Wales seek medical advice for a skin condition, and approximately 6% of patients presenting with a skin problem are referred for specialist advice each year.[18]
The Department of Health encourages the use of digital technology in key areas to support delivery of the quality, innovation, productivity, and prevention (QIPP). This includes the introduction of digital or online services to deliver greater convenience for patients and to free up face-to-face clinical time for individuals who really need it.[19]
Brazil
Brazil has had a high influx of white-skinned European immigrants from Portugal, Spain, Italy, Austria, Germany, Poland, Russia, etc., for many centuries. High
in the country.Australia
Teledermatology and teledermoscopy currently exist in different forms in Australia. They assist with combatting the high skin cancer rates and allows rural patients to access specialist advice without having to travel. However, store-and-forward teledermatology or teledermoscopy are not currently funded under the Australian national health scheme called Medicare. Research has been done into the economic impact of funding teledermoscopy in the Australian setting, finding that it would cost around $2 for every day that diagnosis or treatment was expedited.[23] Australian dermatologists have been reported as reflecting on teledermoscopy by saying "that it is valuable, [and] advanced dermatology service" but given the option "they would prefer face-to-face consultation with patients where possible to allow for a full body examination".[24]
See also
- List of cutaneous conditions
References
- ^ "ATA Teledermatology SIG". American Telemedicine Association. Archived from the original on 2 February 2007.
- ISBN 978-1-351-98946-6.
- S2CID 41450493.
- ^ Burg G, Soyer HP, Chimenti S (2005). "Teledermatology". In Frisch P, Burgdorf W (eds.). EDF White Book, Skin Diseases in Europe. Berlin. pp. 130–133.
{{cite book}}
: CS1 maint: location missing publisher (link) - PMID 7703938.
- PMID 30521686.
- ^ "Telederm.org". eDermConsult.
- PMID 18086999.
- PMID 30222518.
- ^ "IDD International Dermoscopy Diploma". Medizinische Universität Graz. Archived from the original on 13 January 2011.
- ^ "DermNet NZ". New Zealand Dermatological Society.
- PMID 17270240.
- S2CID 39413421.
- ^ "Handyscope". FotoFinder Systems GmbH. Archived from the original on 10 April 2020. Retrieved 27 November 2018.
- S2CID 4052611.
- PMID 30521685.
- PMID 19172028.
- ^ Schofield J, Grindlay D, Williams H. Skin conditions in the UK: a health care needs assessment. Nottingham: Centre of Evidence Based Dermatology, University of Nottingham, 2009.
- ^ "The Operating Framework for the NHS in England 2011/12". Department of Health. GOV.UK.
- ^ "Skin cancer responds to around 30% of all malignant tumors in the Country". Sociedade Brasileira de Medicina Tropical (in Portuguese). 2019.
- S2CID 54165649.
- PMID 31409225.
- PMID 29801161.
- S2CID 49389361.
Further reading
- R Wootton R, Oakley A (2002). Teledermatology. Royal Society of Medicine Press Ltd.
- Soyer HP, Hofmann-Wellenhof R, Massone C, Gabler G, Dong H, Ozdemir F, Argenziano G (April 2005). "telederm.org: freely available online consultations in dermatology". PLOS Medicine. 2 (4): e87. PMID 15839749.
- Ebner C, Gabler G, Massone C, Hofmann-Wellenhof R, Lozzi GP, Wurm EM, Soyer HP (2006). "Mobile Teledermatology coming of age". Elektrotechnik und Informationstechnik. 123 (4): 148–151. S2CID 19556047.
- Scheinfeld N, Fisher M, Genis P, Long H (2003). "Evaluating patient acceptance of a teledermatology link of an urban urgent-care dermatology clinic run by residents with board certified dermatologists". Skinmed. 2 (3): 159–62. PMID 14673291.
- Lipozencić J, Pastar Z, Janjua SA (2007). "Teledermatology". Acta Dermatovenerologica Croatica. 15 (3): 199–201. PMID 17868546.
External links
Systematic review of economic evidence