University of Connecticut School of Medicine, Farmington, CT, USA.
Department of Internal Medicine, University of Connecticut School of Medicine, Farmington, CT, USA.
J Telemed Telecare. 2024 Apr;30(3):519-526. doi: 10.1177/1357633X211068275. Epub 2021 Dec 28.
There are few studies focusing on pediatric teledermatology, and the impact of a large-scale pediatric teledermatology program on the accessibility and efficiency of dermatology care remains unclear. This study evaluated the impact of a state-wide implementation of a store-and-forward teledermatology program augmented by the incorporation of dermoscopy in pediatric patients visiting community health centers.
It was a descriptive, retrospective cohort study of 876 pediatric dermatology referrals.
In the traditional referral system, only 60 patients (17.6%) were seen by dermatologists with average waiting times of 75 days due to limited access. In comparison, with an implementation of dermoscopy-aided teledermatology, all 536 teledermatology referrals received dermatological care within 24 h, of which only 64 (12%) patients requires face-to-face (F2F) consultation. Patients referred for F2F consultation via eConsults had a much lower no-show rate as compared to the traditional referral system (39% vs. 71%). Side by side comparison between general population and pediatric population has demonstrated shared features in efficiency and access improvement but revealed specific characteristics of pediatric teledermatology in terms of diagnosis and treatment.
Coordinated store-and-forward teledermatology platform with incorporation of dermoscopy between large community care network and dermatology provider can greatly improve access to pediatric dermatology care especially in underserved population. The efficiency of teledermatology in access improvement for pediatric population is comparable with adult population in eConsults. There are also unique features and challenges in pediatric teledermatology that require further research.
目前针对儿科远程皮肤病学的研究较少，且大规模儿科远程皮肤病学项目对皮肤病学护理的可及性和效率的影响尚不清楚。本研究评估了在全州范围内实施存储转发远程皮肤病学计划并结合皮肤镜检查对社区卫生中心就诊的儿科患者的影响。
这是一项针对 876 例儿科皮肤病学转诊患者的描述性、回顾性队列研究。
在传统转诊系统中，由于可及性有限，只有 60 名患者（17.6%）接受了皮肤科医生的治疗，平均等待时间为 75 天。相比之下，通过实施皮肤镜辅助远程皮肤病学，所有 536 例远程皮肤病学转诊患者都在 24 小时内得到了皮肤科护理，其中只有 64 名（12%）患者需要面对面（F2F）咨询。通过电子咨询进行 F2F 咨询转诊的患者的失约率明显低于传统转诊系统（39%比 71%）。一般人群和儿科人群的并排比较表明，在效率和可及性改善方面具有共同特征，但在诊断和治疗方面揭示了儿科远程皮肤病学的特定特征。
在大型社区护理网络和皮肤科医生之间协调的存储转发远程皮肤病学平台，结合皮肤镜检查，可以极大地改善儿科皮肤病学的可及性，特别是在服务不足的人群中。电子咨询中远程皮肤病学在改善儿科人群获得服务方面的效率与成人人群相当。儿科远程皮肤病学也有其独特的特点和挑战，需要进一步研究。
