Kanthraj Garehatty Rudrappa
Department of Dermatology, Venereology and Leprosy, J. S. S. Medical College Hospital, J. S. S. University, Mahatma Gandhi Road, Mysore, Karnataka, India.
Indian J Dermatol Venereol Leprol. 2015 Mar-Apr;81(2):136-43. doi: 10.4103/0378-6323.152172.
Recent teledermatology practice has been focused on different models made possible by robust advances in information technology leading to consistent interaction between the patient and health care professionals. Patient-assisted teledermatology practice also called patient-enabled teledermatology or home based teledermatology is one such novel model. There is a lack of scientific literature and substantive reviews on patient-assisted teledermatology practice. The present article reviews several studies and surveys on patient-assisted teledermatology practice and outlines its advantages and barriers to clinical utility and analyses the potentiality of this concept. Incorporating patient-assisted teledermatology practice as a novel model in the revised classification of teledermatology practice is proposed. In patient-assisted teledermatology, the patient can upload his/her clinical images as a first contact with the dermatologist or an initial face-to-face examination can be followed by teledermatology consultations. The latter method is well suited to chronic diseases such as psoriasis, vitiligo, and leg ulcers, which may need frequent follow-up entailing significant costs and time, particularly in the elderly. Teledermatology may also be used by the treating dermatologist to seek expert opinion for difficult cases. Studies have demonstrated the importance and usability of the concept of patient-assisted teledermatology practice. Various teledermatology care models are available and the appropriate model should be chosen depending on whether the clinical situation is that of easily diagnosed cases ("spotters"), chronic cases or doubtful cases and difficult-to-manage cases.
近期的远程皮肤病学实践聚焦于信息技术的重大进步所促成的不同模式,这些模式实现了患者与医疗保健专业人员之间的持续互动。患者辅助远程皮肤病学实践,也称为患者启用远程皮肤病学或家庭式远程皮肤病学,就是这样一种新颖的模式。目前缺乏关于患者辅助远程皮肤病学实践的科学文献和实质性综述。本文回顾了几项关于患者辅助远程皮肤病学实践的研究和调查,概述了其优势以及在临床应用中的障碍,并分析了这一概念的潜力。本文建议将患者辅助远程皮肤病学实践作为一种新颖的模式纳入远程皮肤病学实践的修订分类中。在患者辅助远程皮肤病学中,患者可以上传其临床图像作为与皮肤科医生的首次接触,或者在初次面对面检查之后进行远程皮肤病学咨询。后一种方法非常适合银屑病、白癜风和腿部溃疡等慢性病,这些疾病可能需要频繁随访,会带来巨大的成本和时间消耗,尤其是在老年人中。治疗皮肤科医生也可以利用远程皮肤病学为疑难病例寻求专家意见。研究已经证明了患者辅助远程皮肤病学实践这一概念的重要性和实用性。有多种远程皮肤病学护理模式可供选择,应根据临床情况是易于诊断的病例(“筛查病例”)、慢性病病例还是疑难病例以及难以处理的病例来选择合适的模式。