Lamel Sonia, Chambers Cindy J, Ratnarathorn Mondhipa, Armstrong April W
Department of Dermatology, University of California, Davis, 3301 C St, Sacramento, CA 95816, USA.
Arch Dermatol. 2012 Jan;148(1):61-5. doi: 10.1001/archdermatol.2011.1157.
To assess the impact of live interactive teledermatology consultations on changes in diagnosis, disease management, and clinical outcomes.
We conducted a retrospective analysis of 1500 patients evaluated via live interactive teledermatology between 2003 and 2005 at the University of California, Davis. We compared diagnoses and treatment plans between the referring physicians and the teledermatologists. Patients with 2 or more teledermatology visits within a 1-year period were assessed for changes in clinical outcomes.
Academic medical center with an established teledermatology program since 1996.
Medical records were evaluated for 1500 patients who underwent live interactive teledermatology consultation. Patients seen for more than 1 teledermatology visit were included in the clinical outcome assessment.
Live interactive teledermatology consultation.
Changes in diagnosis, disease management, and clinical outcome.
Compared with diagnoses and treatment plans from referring physicians, the 1500 live interactive teledermatology consultations resulted in changes in diagnosis in 69.9% of patients and changes in disease management in 97.7% of patients. Among 313 patients with at least 2 teledermatology visits within 1 year, clinical improvement was observed in 68.7% of patients. Multivariate analysis showed that changes in diagnosis (P = .01), changes in disease management (P < .001), and the number of teledermatology visits (P < .001) were significantly associated with improved clinical outcomes.
Live interactive teledermatology consultations result in changes in diagnosis and disease management in most consultations. The numbers of live interactive teledermatology visits and changes in diagnosis and disease management are significantly associated with improved clinical outcomes.
评估实时交互式远程皮肤病学会诊对诊断、疾病管理和临床结局变化的影响。
我们对2003年至2005年在加利福尼亚大学戴维斯分校通过实时交互式远程皮肤病学评估的1500例患者进行了回顾性分析。我们比较了转诊医生和远程皮肤病医生之间的诊断和治疗方案。对在1年内进行2次或更多次远程皮肤病学会诊的患者评估其临床结局的变化。
自1996年起就设有远程皮肤病学项目的学术医疗中心。
对1500例接受实时交互式远程皮肤病学会诊的患者的病历进行评估。接受不止1次远程皮肤病学会诊的患者纳入临床结局评估。
实时交互式远程皮肤病学会诊。
诊断、疾病管理和临床结局的变化。
与转诊医生的诊断和治疗方案相比，1500例实时交互式远程皮肤病学会诊导致69.9%的患者诊断发生变化，97.7%的患者疾病管理发生变化。在1年内至少进行2次远程皮肤病学会诊的313例患者中，68.7%的患者临床症状改善。多变量分析显示，诊断变化（P = 0.01）、疾病管理变化（P < 0.001）和远程皮肤病学会诊次数（P < 0.001）与临床结局改善显著相关。
实时交互式远程皮肤病学会诊在大多数会诊中会导致诊断和疾病管理发生变化。实时交互式远程皮肤病学会诊次数以及诊断和疾病管理的变化与临床结局改善显著相关。
