Fogel Alexander L, Teng Joyce M C
School of Medicine, Stanford University, Palo Alto, California.
Department of Dermatology, Stanford University, Palo Alto, California.
Pediatr Dermatol. 2015 May-Jun;32(3):363-8. doi: 10.1111/pde.12533. Epub 2015 Feb 18.
Pediatric dermatology is one of the smallest subspecialties, and expanding the availability of care is of great interest. Teledermatology has been proposed as a way to expand access and improve care delivery, but no current assessment of pediatric teledermatology exists. The objective of the current study was to assess usage and perspectives on pediatric teledermatology. Surveys were distributed electronically to all 226 board-certified U.S. pediatric dermatologists; 44% (100/226) responded. Nearly all respondents (89%) have experience with teledermatology. Formal teledermatology reimbursement success rates have increased to 35%. Respondents were positive about teledermatology's present and future prospects, and 41% want to use teledermatology more often, although they viewed teledermatology as somewhat inferior to in-person care regarding accuracy of diagnosis and appropriation of management plans. Significant differences were found between formal teledermatology users and nonusers in salary structure, practice environment, sex, and region. Substantial increases in pediatric teledermatology have occurred in the last 5 to 10 years, and there remains cause for optimism for teledermatology's future. Concerns about diagnostic confidence and care quality indicate that teledermatology may be best for care of patients with characteristic clinical presentations or management of patients with established diagnoses.
儿科皮肤病学是规模最小的亚专业之一,扩大医疗服务的可及性备受关注。远程皮肤病学被提议作为一种扩大就医机会和改善医疗服务提供的方式,但目前尚无对儿科远程皮肤病学的评估。本研究的目的是评估儿科远程皮肤病学的使用情况和相关观点。通过电子方式向所有226名美国儿科皮肤科专科医师发放了调查问卷;44%(100/226)的医师进行了回复。几乎所有回复者(89%)都有远程皮肤病学方面的经验。远程皮肤病学的正式报销成功率已升至35%。回复者对远程皮肤病学的当前和未来前景持积极态度,41%的人希望更频繁地使用远程皮肤病学,尽管他们认为在诊断准确性和治疗方案合理性方面,远程皮肤病学略逊于面对面诊疗。在薪资结构、执业环境、性别和地区方面,正式的远程皮肤病学使用者和非使用者之间存在显著差异。在过去5至10年中,儿科远程皮肤病学有了大幅增长,远程皮肤病学的未来仍值得乐观期待。对诊断信心和医疗质量的担忧表明,远程皮肤病学可能最适合用于具有典型临床表现的患者的诊疗或已确诊患者的管理。