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Published on: August 1, 2019
Implementation of a Teledermatology Electronic Consultation Program to Improve the Care of Patients with Inflammatory
Ana Echarri1, Carmen Pradera1, Gema Molina1
1Department of Gastroenterology, Complejo Hospitalario Universitario de Ferrol, Ferrol, Spain.
Introduction:
Skin lesions are a common extraintestinal manifestation associated with inflammatory bowel disease (IBD), although they may also appear as a complication of IBD treatment. Prompt referral to the dermatologist can be very helpful in practice. Teledermatology complements the traditional in-person health care modality, improving access to dermatological care.
Objective:
To evaluate the impact of a store-and-forward teledermatology electronic consultation (e-consult) program on the care of IBD patients.
Methods:
A retrospective study assessing the outcomes of our teledermatology program over its first 2 years of implementation.
Results:
A total of 39 consultations involving 33 patients (69.2% women, mean age 39.6 years [12-63]) were conducted. The mean number of teleconsultations was 2.8 per month in the initial implementation stage: 33 consultations were carried out in patients with Crohn's disease and 6 in ulcerative colitis. Only 18% of the patients had an active flare-up. The most frequent reason for the e-consult was paradoxical psoriasiform lesions (n = 13, 33.3%), commonly related with anti-tumor necrosis factor agents (70% of the patients) and hidradenitis suppurativa (n = 4, 10.3%). Resolution was achieved in 87% of patients, with a mean waiting time of 4.7 days (0-14). Almost all patients (97%) were satisfied with our program, and considered the referral through the program to be appropriate (92%). Best valued features were the reduced waiting time and the coordinated approach between the two departments involved.
Conclusions:
Dermatology e-consult is an efficient and useful means of optimizing IBD patient care.
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