Shah Vrusha K, Jaklitsch Erik, Agarwal Ashima, Chen Jeffrey, James Alaina J, Ferris Laura K, English Joseph C, Nekooie Batool, Choudhary Sonal
Department of Dermatology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Department of Electrical Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA.
Telemed J E Health. 2024 Jan;30(1):204-213. doi: 10.1089/tmj.2023.0079. Epub 2023 Jun 26.
Background:Implementation of teledermatology for assessing dermatitis patients provides comparable diagnostic and management outcomes to in-person visits, but studies on consumer to physician asynchronous teledermatology (eDerm) consults submitted by patients in large dermatitis cohorts are limited. The objective of this study was to retrospectively assess associations of eDerm consults with diagnostic accuracy, management, and follow-up in a large cohort of dermatitis patients.
Methods:One thousand forty-five eDerm encounters between April 1, 2020, and October 29, 2021, recorded in the University of Pittsburgh Medical Center Health System Epic electronic medical record were reviewed. Descriptive statistics and concordance were analyzed using chi-square.
Results:Asynchronous teledermatology modified/changed treatment in 97.6% of cases and had the same diagnosis between teledermatology and in-person follow-up in 78.3% of cases. Patients following up in the time line requested were more likely to follow-up in person (61.2% vs. 43.8%) than those who did not. Patients with intertriginous dermatitis (p = 0.003), preexisting conditions (p = 0.002), who required follow-ups (<0.0001), and moderate-high severity scores of 4-7 (p = 0.019) were more likely to follow up in the time line requested.
Limitations:Lack of similar in-person visit data did not allow us to compare descriptive and concordance data between eDerm and clinic visits.
Conclusions:eDerm offers a quick accessible solution to provide comparable dermatologic care for patients with dermatitis.
实施远程皮肤病学用于评估皮炎患者，其诊断和管理结果与面对面就诊相当，但关于大型皮炎队列中患者提交的消费者与医生异步远程皮肤病学（电子皮肤病学，eDerm）咨询的研究有限。本研究的目的是回顾性评估在一大群皮炎患者中，eDerm咨询与诊断准确性、管理及随访之间的关联。
回顾了2020年4月1日至2021年10月29日期间记录在匹兹堡大学医学中心健康系统Epic电子病历中的1045次eDerm会诊。使用卡方分析描述性统计和一致性。
异步远程皮肤病学在97.6%的病例中修改/改变了治疗方案，在78.3%的病例中远程皮肤病学与面对面随访的诊断相同。按要求的时间线进行随访的患者比未按要求时间线随访的患者更有可能亲自进行随访（61.2%对43.8%）。患有间擦疹性皮炎的患者（p = 0.003）、有既往病史的患者（p = 0.002）、需要随访的患者（<0.0001）以及中度至高度严重程度评分为4 - 7分的患者（p = 0.019）更有可能按要求的时间线进行随访。
缺乏类似的面对面就诊数据，这使我们无法比较eDerm与门诊就诊之间的描述性和一致性数据。
eDerm为皮炎患者提供了一种快速便捷的解决方案，以提供可比的皮肤科护理。
