Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease

Colleen K. Gabel, Emily Nguyen, Ryan Karmouta, Kristina J. Liu, Guohai Zhou, Allireza Alloo, Ryan Arakaki, Yevgeniy Balagula, Alina G. Bridges, Edward W. Cowen, Mark Denis P. Davis, Alisa Femia, Joanna Harp, Benjamin Kaffenberger, Jesse J. Keller, Bernice Y. Kwong, Alina Markova, Melissa Mauskar, Robert Micheletti, Arash MostaghimiJoseph Pierson, Misha Rosenbach, Zachary Schwager, Lucia Seminario-Vidal, Victoria R. Sharon, Philip I. Song, Lindsay C. Strowd, Andrew C. Walls, Karolyn A. Wanat, David A. Wetter, Scott Worswick, Carolyn Ziemer, Joseph Kvedar, Anar Mikailov, Daniela Kroshinsky

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Patient outcomes are improved when dermatologists provide inpatient consultations. Inpatient access to dermatologists is limited, illustrating an opportunity to use teledermatology. Little is known about the ability of dermatologists to accurately diagnose disease and manage inpatients with teledermatology, particularly when using nondermatologist-generated clinical data. Methods: This prospective study assessed the ability of teledermatology to diagnose disease and manage 41 dermatology consultations from a large urban tertiary care center, using internal medicine referral documentation and photographs. Twenty-seven dermatology hospitalists were surveyed. Interrater agreement was assessed by the κ statistic. Results: There was substantial agreement between in-person and teledermatology assessment of the diagnosis with differential diagnosis (median κ = 0.83), substantial agreement in laboratory evaluation decisions (median κ = 0.67), almost perfect agreement in imaging decisions (median κ = 1.0), and moderate agreement in biopsy decisions (median κ = 0.43). There was almost perfect agreement in treatment (median κ = 1.0), but no agreement in follow-up planning (median κ = 0.0). There was no association between raw photograph quality and the primary plus differential diagnosis or primary diagnosis alone. Limitations: Selection bias and single-center nature. Conclusions: Teledermatology may be effective in the inpatient setting, with concordant diagnosis, evaluation, and management decisions.

Original languageEnglish (US)
Pages (from-to)1547-1553
Number of pages7
JournalJournal of the American Academy of Dermatology
Volume84
Issue number6
DOIs
StatePublished - Jun 2021

Keywords

  • dermatology consultations
  • dermatology hospitalists
  • inpatient dermatology
  • store-and-forward
  • teledermatology
  • telemedicine

ASJC Scopus subject areas

  • Dermatology

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