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Implementation of a pediatric provider-to-provider store-and-forward teledermatology system: Effectiveness,
Olivia S Jew1,2,3, Aditi S Murthy1,4, Kristen Danley5
1Section of Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Insights
Store-and-forward teledermatology effectively connects pediatric patients with dermatologists, reducing wait times and improving care access. This method is feasible, acceptable, and enhances the quality of pediatric dermatology services.
Area of Science:
- Pediatric Dermatology
- Digital Health
- Health Services Research
Background:
- Long wait times for pediatric dermatology appointments delay care and increase costs.
- Teledermatology offers a potential solution to improve access and efficiency in pediatric specialty care.
Purpose of the Study:
- To evaluate the feasibility and effectiveness of store-and-forward teledermatology in pediatric dermatology.
- To assess patient and provider satisfaction with teledermatology consultations.
Main Methods:
- Prospective, non-blinded cohort study involving primary care providers and pediatric dermatologists.
- Utilized a shared electronic medical record for teledermatology consultations.
- Follow-up surveys collected parent and provider feedback.
Main Results:
- 43 consultations were completed, with a median time of 12.1 hours from request to initiation.
- Recommendations were conveyed to families within a median of 3 days.
- 98% of consultations followed the intended workflow; 83% of parents would recommend the service.
Conclusions:
- Provider-to-provider teledermatology is a feasible and acceptable method for delivering pediatric dermatology care.
- The service demonstrates potential for quick and effective care delivery, improving patient outcomes and satisfaction.
Background/Objectives:
Long wait times for in-person appointments in pediatric dermatology can lead to delays in specialty care, additional health system touchpoints, patient and family dissatisfaction, poorer outcomes, and increased overall health care costs. Store-and-forward teledermatology may address these challenges and improve access to care in pediatric dermatology.
Methods:
We describe a prospective, non-blinded cohort study with follow-up surveys conducted from March 1, 2018, to September 20, 2018. The study was conducted at a single center, in primary care and specialist settings. Patients included were <18 years old and received care at one of our affiliated primary care sites. Primary care providers submitted teledermatology consultations through a shared electronic medical record. A board-certified pediatric dermatologist evaluated each consultation; primary care providers conveyed recommendations to families.
Results:
Forty-three consultations for patients (23 male, 20 female; median age: 7 years [IQR: 2.4-12]) were entered by primary care providers. Median time from consult request to dermatologist initiating consult was 12.1 hours [IQR: 1.9-18.8]; median time to complete consult note was 7 minutes [IQR: 5-10.5]. Median time from primary care provider initially consulting to conveying teledermatology recommendations to families was 3 days [IQR: 1-5]. All but one consult (42/43, 98%) were completed in the intended workflow. Follow-up in-person visits with pediatric dermatologists occurred with 10/43 (23%) patients. In follow-up surveys, parents were 83% likely to recommend the service to family and friends. All primary care providers and dermatologists felt the service improved quality of care.
Conclusions:
Provider-to-provider teledermatology consultation appears to be a feasible and acceptable method of providing care quickly and effectively to pediatric patients.
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