Dermatoepidemiology Unit, Providence Veterans Affairs Medical Center, Providence, Rhode Island; Department of Dermatology, Warren Alpert Medical School of Brown University, Providence, Rhode Island.
Institute of Medical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts.
J Am Acad Dermatol. 2014 Sep;71(3):570-6. doi: 10.1016/j.jaad.2014.02.021. Epub 2014 Apr 3.
Teledermatology makes 3 promises: better, cheaper, and faster dermatologic care. It is "better" because, although it cannot offer as much to the patient as a traditional visit, it extends the dermatologist's reach to places and in ways not previously possible as a result of time and place limitations; it is "cheaper and faster" because it has the potential to reduce costs and increase efficiency for both patients and providers. For teledermatology to fulfill these promises, it must enable dermatologists to improve access by increasing the number of patients evaluated and treated. Increased patient access depends on maximizing a scarce resource-dermatologists' time-in part by avoiding unnecessary and time-consuming face-to-face appointments. We examined the literature to date to determine which teledermatology programs have greater or lesser success in reducing face-to-face visits. Our review highlights 4 factors that are associated with a higher number of face-to-face appointments avoided by teledermatology programs: (1) effective preselection of patients for teleconsultation, (2) high-quality photographic images, (3) dermoscopy if pigmented lesions are evaluated, and (4) effective infrastructure and culture in place to implement teleconsultation recommendations.
更好、更便宜、更快的皮肤病护理。它“更好”，因为虽然它不能像传统就诊那样为患者提供那么多服务，但它通过时间和地点的限制，扩大了皮肤科医生的服务范围和方式；它“更便宜、更快”，因为它有可能降低患者和提供者的成本和提高效率。为了实现这些承诺，远程皮肤病学必须使皮肤科医生能够通过增加评估和治疗的患者数量来改善获得服务的机会。增加患者就诊机会取决于最大限度地利用皮肤科医生的稀缺资源——时间，部分方法是避免不必要的和耗时的面对面预约。我们查阅了迄今为止的文献，以确定哪些远程皮肤病学项目在减少面对面就诊方面取得了更大或更小的成功。我们的综述强调了四个与远程皮肤病学项目避免更多面对面预约相关的因素：（1）有效选择远程咨询患者，（2）高质量的图像，（3）如果评估色素性病变则进行皮肤镜检查，以及（4）有效实施远程咨询建议的基础设施和文化。
