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[在新冠疫情期间一所学术性皮肤科科室中远程皮肤病学的快速实施]

[Rapid implementation of tele-dermatology during COVID-19 pandemic in an academic dermatology department].

作者信息

Ramírez-Cornejo Cristian, Muñoz-López Camila, Del Barrio-Díaz Pablo, Jaque Alejandra, Majerson Daniela, Navarrete-Dechent Cristián, Uribe Pablo, Vera-Kellet Cristián

机构信息

Departamento de Dermatología, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile.

出版信息

Rev Med Chil. 2021 Oct;149(10):1467-1472. doi: 10.4067/s0034-98872021001001467.

Abstract

BACKGROUND

The day after COVID-19 quarantine started, we initiated patient care through Tele-dermatology.

AIM

To report the experience of the implementation of Telemedicine in dermatology and to assess its impact on the number of dermatological visits compared with the pre-pandemic period.

MATERIAL AND METHODS

The study was conducted between March 27th, 2020, and April 30th, 2020. All patients submitted clinical images of their skin condition via secure email before the telemedicine visit. All telemedicine visits were conducted using the Zoom video conferencing platform. Patient demographics and medical history were recorded. If the dermatologist was unable to reach a diagnosis, the patient was sent for an in-person visit, skin biopsy, or additional laboratory workup.

RESULTS

We recorded 1,357 Tele dermatology visits from 1,222 patients aged 29 ± 18 years (38% males). Visits increased from 104 to 298 from the first to the last week, corresponding to 17% of the patient volume seen before the pandemic (1,709 in-person patients/week). A preliminary diagnosis was made in 95% of cases. Ninety percent of patients sent photos. Fifty eight percent of cases were chronic diseases, and were classified as inflammatory in 68%, infectious in 15%, neoplastic/tumoral in 7%, or other conditions in 11%. Less than 1% of these visits were COVID-19 related.

CONCLUSIONS

In this prospective study of Tele-dermatology lasting five weeks, a preliminary diagnosis could be made in approximately 95% of cases and in the first five weeks of implementation, a volume of consultations equivalent to 17% of those made in the pre-pandemic period was carried out. Therefore, Tele-dermatology can be implemented quickly and successfully in practices when healthcare access is limited.

摘要

背景

在新冠疫情隔离开始后的第二天,我们通过远程皮肤病学开展患者护理工作。

目的

报告远程医疗在皮肤病学领域的实施经验,并评估其与疫情前时期相比对皮肤科就诊人数的影响。

材料与方法

该研究于2020年3月27日至2020年4月30日进行。所有患者在远程医疗就诊前通过安全电子邮件提交其皮肤状况的临床图像。所有远程医疗就诊均使用Zoom视频会议平台进行。记录患者的人口统计学信息和病史。如果皮肤科医生无法做出诊断,则将患者送去进行面对面就诊、皮肤活检或额外的实验室检查。

结果

我们记录了1222名年龄在29±18岁(38%为男性)患者的1357次远程皮肤病学就诊。就诊次数从第一周的104次增加到最后一周的298次,相当于疫情前每周就诊患者数量(1709名面对面就诊患者)的17%。95%的病例做出了初步诊断。90%的患者发送了照片。58%的病例为慢性病,其中68%为炎症性疾病,15%为感染性疾病,7%为肿瘤性疾病,11%为其他疾病。这些就诊中与新冠疫情相关的不到1%。

结论

在这项为期五周的远程皮肤病学前瞻性研究中,约95%的病例可做出初步诊断,并且在实施的前五个星期内,进行的会诊数量相当于疫情前时期的17%。因此,当医疗服务受限的时候,远程皮肤病学可以在医疗机构中快速且成功地实施。

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