A new Penn Medicine study shows that remote consultations from dermatologists using a secure smart phone app are reliable at prioritizing care for hospitalized patients with skin conditions. Researchers in the Perelman School of Medicine at the University of Pennsylvania report in JAMA Dermatology that this teledermatology process is reliable and can help deliver care more efficiently in busy academic hospitals and potentially in community hospital settings. A national shortage and uneven distribution of dermatologists in the United States has caused scheduling concerns in both the inpatient and outpatient settings.
Many hospitals do not have inpatient dermatology consultative services, and those that do often have limited availability for consults after hours and on weekends.
"Dermatology support is essential for hospitalized patients, but unfortunately many hospitals lack dermatology coverage. Teledermatology may help optimize time spent by dermatologists in the inpatient setting by potentially reducing or eliminating trips to the hospital, and allowing some dermatologists to batch consultations or schedule non-urgent inpatients to be seen after discharge for outpatient appointments," said senior study author Misha Rosenbach, MD, assistant professor of Dermatology and director of the Dermatology inpatient dermatology service at Penn Medicine. "A substantial agreement between in-person and teledermatology consultants in this study demonstrates the reliability and potential of this platform."
The new study compared assessments of 50 hospitalized patients in a high acuity academic medical center, the Hospital of the University of Pennsylvania, between a face-to-face consultation with an inpatient dermatologist and a standardized teledermatology consultation with two experienced tele dermatologists.
When the inpatient dermatologist recommended a patient be seen the same day, the teledermatologists independently suggested the same course of action in 90 percent of cases. The teledermatologists agreed in 95 percent of cases where the inpatient dermatologist had recommended a biopsy. The doctors completely agreed on a diagnosis 82 percent of the time, and partially agreed in 88 percent of cases, which is in line with the standard variation expected between providers.
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