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在 COVID-19 大流行期间,利用远程皮肤病学服务进行皮肤病诊断。

Utilization of teledermatology services for dermatological diagnoses during the COVID-19 pandemic.

机构信息

Department of Dermatology, The University of Texas Southwestern Medical Center, 5939 Harry Hines Blvd, Dallas, TX, 75390, USA.

Naveen Jindal School of Management, The University of Texas at Dallas, Richardson, TX, USA.

出版信息

Arch Dermatol Res. 2023 May;315(4):1059-1062. doi: 10.1007/s00403-022-02438-9. Epub 2022 Nov 3.

Abstract

Little is known about trends in teledermatology adoption and use for managing dermatologic patients, especially changes in use influenced by the COVID-19 pandemic. In this retrospective cohort study, we analyzed encounter data from the Healthjump dataset (containing electronic health record data from throughout the USA) for visits from November 2019 to July 2021 with a primary dermatology-related diagnosis. There was a striking rise in teledermatology use with the onset of the pandemic in February 2020, peaking in April 2020 with 2178 teledermatology encounters (32.8% of all encounters). Subsequently, teledermatology use waned. Most teledermatology care was delivered via synchronous means with little use of asynchronous or telephone communication. When compared to those with neoplastic skin diseases, patients with inflammatory skin diseases were more likely to be seen via teledermatology (OR 3.30, 95% CI 3.12-3.49). Certain demographic groups were less likely to receive care via teledermatology, such as men (compared with females, OR 0.76, 95% CI 0.74-0.78) and patients 65 and older (compared with those below 65, OR 0.59, 95% CI 0.57-0.62). Our work shows increased adoption of teledermatology at the onset of the COVID-19 pandemic with decreasing use over time. Future efforts are needed to ensure continued and expanded use of a valuable care modality to reach vulnerable populations.

摘要

人们对远程皮肤病学的采用和使用趋势知之甚少,特别是在 COVID-19 大流行影响下的使用变化。在这项回顾性队列研究中,我们分析了来自 Healthjump 数据集(包含美国各地的电子健康记录数据)的就诊数据,这些就诊记录来自 2019 年 11 月至 2021 年 7 月期间具有主要皮肤病相关诊断的就诊记录。自 2020 年 2 月 COVID-19 大流行开始以来,远程皮肤病学的使用显著增加,2020 年 4 月达到峰值,有 2178 次远程皮肤病学就诊(占所有就诊的 32.8%)。随后,远程皮肤病学的使用逐渐减少。大多数远程皮肤病学护理通过同步方式提供,异步或电话沟通的使用很少。与患有肿瘤性皮肤病的患者相比,患有炎症性皮肤病的患者更有可能通过远程皮肤病学就诊(OR 3.30,95%CI 3.12-3.49)。某些人群不太可能通过远程皮肤病学接受治疗,例如男性(与女性相比,OR 0.76,95%CI 0.74-0.78)和 65 岁及以上的患者(与 65 岁以下的患者相比,OR 0.59,95%CI 0.57-0.62)。我们的工作表明,在 COVID-19 大流行开始时,远程皮肤病学的采用率有所增加,随着时间的推移使用量逐渐减少。未来需要努力确保继续扩大这种有价值的护理模式的使用,以覆盖弱势群体。

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