Bertin C, Diakite A, Carton B, Wozniak C, Nathanson S, Monnier S, Sin C, Dommergues M-A, Parigot J, Moreau F, Sigal M-L, Foucaud P, Greder A, Mahé E
Service de dermatologie, centre hospitalier Victor-Dupouy, 69, rue du Lieutenant-Colonel Prud'hon, 95100 Argenteuil, France.
Unité de consultations et soins ambulatoires, Maison d'Arrêt-de-Bois-d'Arcy, centre hospitalier de Versailles, 5, rue Alexandre-Turpault, 78390 Bois-d'Arcy, France; Unité de consultations et soins ambulatoires, Maison d'Arrêt de Versailles, centre hospitalier de Versailles, 28, avenue de Paris, 78000 Versailles, France.
Ann Dermatol Venereol. 2017 Dec;144(12):759-767. doi: 10.1016/j.annder.2017.06.011. Epub 2017 Aug 10.
Teledermatology is currently booming. Due to the shortage of dermatologists in hospitals access to dermatological consultations is very limited in some hospitals. We present our experience of collaboration between an expert center, the dermatology department of the Victor-Dupouy Hospital Centre in Argenteuil, and all medical structures under the André-Mignot Hospital in Versailles (CHV), including 2 prison medical centers (UCSA), traditional departments and emergency department.
Teledermatology, developed in the form of tele-expertise, began at the UCSA in November 2013. This expertise was then extended in June 2014 to the Internal Medicine department of CHV, and in December 2014 to all departments, including the emergency department. The rules and ethics of teledermatology were strictly adhered to. While UCSA could file all expertise dossiers, only urgent or difficult cases could be filed by other CHV departments.
In 26 months, 347 expertise requests were filed: 231 by prisons and 116 by the other departments of the CHV. No patients refused teledermatology. The quality of information and photographs was considered good or excellent in over 95% of cases. A response was given within 3hours in more than 50% of cases and in all cases within 24hours (on working days). Analysis of diseases diagnosed illustrates the wide variety of conditions encountered in dermatology, with different structures having their own specific features.
Our example illustrates the possibility of developing such an inter-hospital platform. However, it does not yet cater for requests made by patients to dermatologists, by dermatologists to dermatologists, or by dermatologists to the hospital teledermatology department. Acceptability was considered excellent by patients (with no refusals), physicians at the CHV, and the expert center.
远程皮肤病学目前正在蓬勃发展。由于医院皮肤科医生短缺,一些医院获得皮肤科会诊的机会非常有限。我们介绍了一个专家中心,即阿让特伊维克托 - 迪普伊医院中心的皮肤科,与凡尔赛安德烈 - 米尼奥医院(CHV)下属的所有医疗结构之间的合作经验,其中包括2个监狱医疗中心(UCSA)、传统科室和急诊科。
以远程专家会诊形式开展的远程皮肤病学于2013年11月在UCSA启动。2014年6月,这种专家会诊扩展到CHV的内科,2014年12月扩展到所有科室,包括急诊科。严格遵守远程皮肤病学的规则和伦理规范。虽然UCSA可以提交所有专家会诊档案,但CHV的其他科室只能提交紧急或疑难病例。
在26个月内,共提交了347份专家会诊申请:监狱提交了231份,CHV的其他科室提交了116份。没有患者拒绝远程皮肤病学服务。在超过95%的病例中,信息和照片的质量被认为良好或优秀。超过50%的病例在3小时内得到回复,所有病例(工作日)在24小时内得到回复。对诊断疾病的分析表明,皮肤科遇到的病症种类繁多,不同结构有其自身特点。
我们的例子说明了开发这样一个医院间平台的可能性。然而,它尚未满足患者向皮肤科医生、皮肤科医生之间或皮肤科医生向医院远程皮肤科提出的请求。患者、CHV的医生和专家中心认为可接受性极佳(没有拒绝情况)。