Stephan Brigitte, Gehrdau Kathrin, Sorbe Christina, Augustin Matthias, Scherer Martin, Kis Anne
Institute for Health Services Research in Dermatology and Nursing, University Medical Center Hamburg-Eppendorf, Martinistraße 52, Hamburg, 20246, Germany, 49 40741055428.
A+ Videoclinic GmbH, Munich, Germany.
JMIR Med Inform. 2025 May 7;13:e58712. doi: 10.2196/58712.
Teledermatology consultations offer the advantage of rapid diagnosis and care. Since 2019, our institute at the University Medical Center Hamburg-Eppendorf has been part of an interdisciplinary team for teledermatology support in German prisons as an alternative to extramural transports of patients.
This study aims to analyze the benefits and limitations of teledermatology for patients with limited access to medical specialties.
We conducted a descriptive cross-sectional analysis of 651 teleconsultations from prisons from February 2020 to April 2023. All cases were performed in a store-and-forward (asynchronous mode) and optional hybrid live (synchronous) consultation for the patient or in-house staff.
The main advantage of this case processing was the avoidance of external transport. Of the 651 teleconsultations, 608 (93.4%) could be finalized with telemedical support and 43 (6.6%) required additional workup, including verifications of the type of tumors (n=22, 51%), which needed biopsies, and open cases that were inflammatory (n=11, 26%) or involved infectious skin conditions (n=5, 12%). Digital imaging of the skin lesions improved with the experience of the personnel but remained a challenge, with the photo quality depending on the technical devices or available broadband supply.
Hybrid teledermatology consultation represents an effective and resource-saving method of providing specialized care to patients in situations with limited access to medical specialties. The video consultations with experts and exchange of knowledge about the cases presented opened the opportunity to support and train intramural colleagues. One of the main challenges remains the quality of digital imaging and transmission.
远程皮肤病学会诊具有快速诊断和治疗的优势。自2019年以来，我们位于汉堡-埃彭多夫大学医学中心的研究所一直是德国监狱远程皮肤病学支持跨学科团队的一部分，作为患者院外转运的替代方案。
本研究旨在分析远程皮肤病学对获得医疗专科服务受限患者的益处和局限性。
我们对2020年2月至2023年4月来自监狱的651次远程会诊进行了描述性横断面分析。所有病例均以存储转发（异步模式）以及为患者或内部工作人员提供的可选混合实时（同步）会诊方式进行。
这种病例处理方式的主要优势是避免了外部转运。在651次远程会诊中，608次（93.4%）在远程医疗支持下可以完成，43次（6.6%）需要进一步检查，包括肿瘤类型的核实（n = 22，51%）——这需要活检——以及炎症性（n = 11，26%）或涉及感染性皮肤病的未决病例（n = 5，12%）。随着工作人员经验的增加，皮肤病变的数字成像有所改善，但仍然是一个挑战，照片质量取决于技术设备或可用的宽带供应。
混合远程皮肤病学会诊是一种在获得医疗专科服务受限的情况下为患者提供专科护理的有效且节省资源的方法。与专家的视频会诊以及对所呈现病例的知识交流为支持和培训狱内同事提供了机会。主要挑战之一仍然是数字成像和传输的质量。
