nach oben

Current Dermatology Reports

Erschienen in:

02.04.2022 | Teledermatology (D Oh, Section Editor)

Inpatient Teledermatology: a Review

verfasst von: Joseph Mocharnuk, Trevor Lockard, Corey Georgesen, Joseph C English

Erschienen in: Current Dermatology Reports | Ausgabe 2/2022

Einloggen, um Zugang zu erhalten

Abstract

Purpose of Review

Inpatient teledermatology is a rapidly growing field with significant potential to add value and streamline patient care. This review summarizes the current literature on inpatient teledermatology, primarily focusing on its diagnostic and clinical management utility as compared to live dermatologic evaluation.

Recent Findings

The COVID-19 pandemic has accelerated the adoption of inpatient teledermatology, which has been shown to be comparable to live hospitalist evaluation for triage, diagnosis, and management of hospitalized patients for a wide variety of conditions. Despite its comparative cost-effectiveness and recent changes in reimbursement practices, inpatient teledermatology still lacks sufficient reimbursement incentive for widespread implementation.

Summary

Inpatient teledermatology is an effective, efficient, accurate, and cost-effective means of managing the hospital burden of skin disease, especially in areas where access to dermatologic care is limited. It is essential that dermatologists and referring providers comprehend the use and potential pitfalls of inpatient teledermatology to effectively incorporate it into hospital practice.

Sherban A, Keller M. The role of inpatient dermatology consultations. Cutis. 2021;108(4):193–6. https://doi.org/10.12788/cutis.0361.CrossRefPubMed

Arnold JD, Yoon S, Kirkorian AY. The national burden of inpatient dermatology in adults. J Am Acad Dermatol. 2019;80(2):425–32. https://doi.org/10.1016/j.jaad.2018.06.070.CrossRefPubMed

Hu L, Haynes H, Ferrazza D, Kupper T, Qureshi A. Impact of specialist consultations on inpatient admissions for dermatology-specific and related DRGs. J Gen Intern Med. 2013;28(11):1477–82. https://doi.org/10.1007/s11606-013-2440-2.CrossRefPubMedPubMedCentral

Madigan LM, Fox LP. Where are we now with inpatient consultative dermatology?: Assessing the value and evolution of this subspecialty over the past decade. J Am Acad Dermatol. 2019;80(6):1804–8. https://doi.org/10.1016/j.jaad.2019.01.031.CrossRefPubMed

Kroshinsky D, Cotliar J, Hughey LC, Shinkai K, Fox LP. Association of dermatology consultation with accuracy of cutaneous disorder diagnoses in hospitalized patients: a multicenter analysis. JAMA Dermatol. 2016;152(4):477–80. https://doi.org/10.1001/jamadermatol.2015.5098.CrossRefPubMed

Nahass GT. Inpatient dermatology consultation. Dermatol Clin. 2000;18(3):533–42, x. https://doi.org/10.1016/s0733-8635(05)70200-x.

American Hospital Association. Fast facts on US Hospitals, 2021. American Hospital Association. 19 January 2022. https://www.aha.org/statistics/fast-facts-us-hospitals

Helms AE, Helms SE, Brodell RT. Hospital consultations: time to address an unmet need? J Am Acad Dermatol. 2009;60(2):308–11. https://doi.org/10.1016/j.jaad.2008.10.024.CrossRefPubMed

Feng H, Berk-Krauss J, Feng PW, Stein JA. Comparison of dermatologist density between urban and rural counties in the United States. JAMA Dermatol. 2018;154(11):1265–71. https://doi.org/10.1001/jamadermatol.2018.3022].CrossRefPubMedPubMedCentral

10.

Weig EA, Tull R, Chung J, Wanat KA. Inpatient teledermatology: current state and practice gaps. J Am Acad Dermatol. 2020;83(3):797–802. https://doi.org/10.1016/j.jaad.2019.07.013.CrossRefPubMed

11.

Sharma P, Kovarik CL, Lipoff JB. Teledermatology as a means to improve access to inpatient dermatology care. J Telemed Telecare. 2016;22(5):304–10. https://doi.org/10.1177/1357633x15603298.CrossRefPubMed

12.

Rosenbach M. The logistics of an inpatient dermatology service. Semin Cutan Med Surg. 2017;36(1):3–8. https://doi.org/10.12788/j.sder.2017.00610.12788/j.sder.2017.006.

13.

• Coustasse A, Sarkar R, Abodunde B, Metzger BJ, Slater CM. Use of teledermatology to improve dermatological access in rural areas. Telemed J E Health. 2019;25(11):1022–32. https://doi.org/10.1089/tmj.2018.0130. Literature review illustrating the power of teledermatology to increase access to care in underserved areas.CrossRefPubMed

14.

Glazer AM, Farberg AS, Winkelmann RR, Rigel DS. Analysis of trends in geographic distribution and density of US dermatologists. JAMA Dermatol. 2017;153(4):322–5. https://doi.org/10.1001/jamadermatol.2016.5411.CrossRefPubMed

15.

Barbieri JS, Nelson CA, James WD, et al. The reliability of teledermatology to triage inpatient dermatology consultations. JAMA Dermatol. 2014;150(4):419–24. https://doi.org/10.1001/jamadermatol.2013.9517.CrossRefPubMed

16.

•• Gabel CK, Nguyen E, Karmouta R, et al. Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease. J Am Acad Dermatol. 2021;84(6):1547–53. https://doi.org/10.1016/j.jaad.2020.04.171. An illustrative study comparing live versus teledermatologist evaluation showing the high reliability of teledermatology to diagnose, manage, and treat a variety of consultations.CrossRefPubMed

17.

Keller JJ, Johnson JP, Latour E. Inpatient teledermatology: diagnostic and therapeutic concordance among a hospitalist, dermatologist, and teledermatologist using store-and-forward teledermatology. J Am Acad Dermatol. 2020;82(5):1262–7. https://doi.org/10.1016/j.jaad.2020.01.030.CrossRefPubMed

18.

Cheeley J, Chen S, Swerlick R. Consultative teledermatology in the emergency department and inpatient wards: a survey of potential referring providers. J Am Acad Dermatol. 2018;79(2):384–6. https://doi.org/10.1016/j.jaad.2018.01.033.CrossRefPubMed

19.

•• Georgesen C, Karim SA, Liu R, Moorhead A, Falo LD Jr, English JC 3rd. Inpatient eDermatology (Teledermatology) Can help meet the demand for inpatient skin disease. Telemed J E Health. 2020;26(7):872–8. https://doi.org/10.1089/tmj.2019.0147. The first large volume of inpatient teledermatology consultations reported from community hospitals with no primary dermatologic care from a distance.CrossRefPubMed

20.

Fox LP. Practice Gaps. Improving accessibility to inpatient dermatology through teledermatology. JAMA Dermatol. 2014;150(4):424–5. https://doi.org/10.1001/jamadermatol.2013.9516.

21.

Dhaduk K, Miller D, Schliftman A, Athar A, Al Aseri ZA, Echevarria A, et al. Implementing and optimizing inpatient access to dermatology consultations via telemedicine: an experiential study. Telemed J E Health. 2021;27(1):68–73. https://doi.org/10.1089/tmj.2019.0267.CrossRefPubMed

22.

Almaziad HM, Alfawzan AI, Alkhayal NK, Alkhodair RA. Assessment of dermatologists’ perception of utilizing teledermatology during COVID-19 pandemic in Saudi Arabia. Saudi Med J. 2021;42(9):1024–30. https://doi.org/10.15537/smj.2021.42.9.20210342.CrossRefPubMed

23.

Kazi R, Evankovich MR, Liu R, Liu A, Moorhead A, Ferris LK, et al. Utilization of asynchronous and synchronous teledermatology in a large health care system during the COVID-19 pandemic. Telemed J E Health. 2021;27(7):771–7. https://doi.org/10.1089/tmj.2020.0299.CrossRefPubMed

24.

• Rismiller K, Cartron AM, Trinidad JCL. Inpatient teledermatology during the COVID-19 pandemic. J Dermatolog Treat. 2020;31(5):441–3. https://doi.org/10.1080/09546634.2020.1762843. Developed a simple algorithm and strict guidelines to prioritize telemedicine specifically for inpatient dermatology consults during COVID-19.CrossRefPubMed

25.

Perkins S, Cohen JM, Nelson CA, Bunick CG. Teledermatology in the era of COVID-19: experience of an academic department of dermatology. J Am Acad Dermatol. 2020;83(1):e43–4. https://doi.org/10.1016/j.jaad.2020.04.048.CrossRefPubMedPubMedCentral

26.

Tan WH, Loh CH, Chai ZT, Oh DAQ, Oh CC, Yeo YW, et al. Early experience of inpatient teledermatology in Singapore during COVID-19. Ann Acad Med Singap. 2021;50(6):487–9. https://doi.org/10.47102/annals-acadmedsg.202130.CrossRefPubMed

27.

Ibrahim AE, Magdy M, Khalaf EM, Mostafa A, Arafa A. Teledermatology in the time of COVID-19. Int J Clin Pract. 2021;75(12):e15000. https://doi.org/10.1111/ijcp.15000.CrossRefPubMed

28.

Brinker TJ, Hekler A, von Kalle C, Schadendorf D, Esser S, Berking C, et al. Teledermatology: comparison of store-and-forward versus live interactive video conferencing. J Med Internet Res. 2018;20(10): e11871. https://doi.org/10.2196/11871.CrossRefPubMedPubMedCentral

29.

Snoswell C, Finnane A, Janda M, Soyer HP, Whitty JA. Cost-effectiveness of store-and-forward teledermatology: a systematic review. JAMA Dermatol. 2016;152(6):702–8. https://doi.org/10.1001/jamadermatol.2016.0525.CrossRefPubMed

30.

Pak HS, Datta SK, Triplett CA, Lindquist JH, Grambow SC, Whited JD. Cost minimization analysis of a store-and-forward teledermatology consult system. Telemed J E Health. 2009;15(2):160–5. https://doi.org/10.1089/tmj.2008.0083.CrossRefPubMed

31.

Whited JD. Teledermatology. Med Clin North Am. 2015;99(6):1365–xiv. https://doi.org/10.1016/j.mcna.2015.07.005.CrossRefPubMed

32.

Tull R, Wanat KA. Teledermatology in the inpatient setting. Semin Cutan Med Surg. 2017;36(1):12–6. https://doi.org/10.12788/j.sder.2017.004.CrossRefPubMed

33.

Viola KV, Tolpinrud WL, Gross CP, Kirsner RS, Imaeda S, Federman DG. Outcomes of referral to dermatology for suspicious lesions: implications for teledermatology. Arch Dermatol. 2011;147(5):556–60. https://doi.org/10.1001/archdermatol.2011.108.CrossRefPubMed

34.

Deacon DC, Madigan LM. Inpatient teledermatology in the era of COVID-19 and the importance of the complete skin examination. JAAD Case Rep. 2020;6(10):977–8. https://doi.org/10.1016/j.jdcr.2020.07.050.CrossRefPubMedPubMedCentral

35.

Okita AL, Molina Tinoco LJ, Patatas OH, Guerreiro A, Criado PR, Gabbi TV, et al. Use of smartphones in telemedicine: comparative study between standard and teledermatological evaluation of high-complex care hospital inpatients. Telemed J E Health. 2016;22(9):755–60. https://doi.org/10.1089/tmj.2015.0086.CrossRefPubMed

36.

Milani-Nejad N, Zhang M, Kaffenberger BH. Association of dermatology consultations with patient care outcomes in hospitalized patients with inflammatory skin diseases. JAMA Dermatol. 2017;153(6):523–8. https://doi.org/10.1001/jamadermatol.2016.6130.CrossRefPubMedPubMedCentral

37.

Joseph J, Truong K, Smith A, Fernandez-Penas P. Dermatology inpatient consultations in a tertiary hospital – a retrospective analysis. Int J Dermatol. 2022;61(1):48–53. https://doi.org/10.1111/ijd.15724.CrossRefPubMed

38.

Davila M, Christenson LJ, Sontheimer RD. Epidemiology and outcomes of dermatology in-patient consultations in a Midwestern U.S. university hospital. Dermatol Online J. 2010;16(2):12.

39.

Muniraj T, Pinevich AJ, Via C, English J. Teaching inpatient dermatology using telemedicine techniques. Academic Internal Medicine Insight. 2012;10(1).

40.

Nelson CA, Wanat KA, Roth RR, James WD, Kovarik CL, Takeshita J. Teledermatology as pedagogy: diagnostic and management concordance between resident and attending dermatologists. J Am Acad Dermatol. 2015;72(3):555–7. https://doi.org/10.1016/j.jaad.2014.11.011.CrossRefPubMedPubMedCentral

41.

• Georgesen C, Karim SA, Liu R, Moorhead A, Falo LD Jr, English JC 3rd. Response: “Distinguishing Stevens-Johnson syndrome/toxic epidermal necrolysis from clinical mimickers during inpatient dermatologic consultation–a retrospective chart review.” J Am Acad Dermatol. 2020;82(3):e111–2. https://doi.org/10.1016/j.jaad.2019.09.087. The study demonstrates first-hand cost savings with inpatient teledermatology as well as the capability of IPTD to triage patients to avoid unnecessary resource use.CrossRefPubMed

42.

Armstrong AW, Chambers CJ, Maverakis E, et al. Effectiveness of online vs in-person care for adults with psoriasis: a randomized clinical trial. JAMA Netw Open. 2018;1:E183062.CrossRef

43.

Parsi K, Chambers CJ, Armstrong AW. Cost-effectiveness analysis of a patient-centered care model for management of psoriasis. J Am Acad Dermatol. 2012;66(4):563–70. https://doi.org/10.1016/j.jaad.2011.02.022.CrossRefPubMed

44.

Morton CA, Downie F, Auld S, Smith B, van der Pol M, Baughan P, et al. Community photo-triage for skin cancer referrals: an aid to service delivery. Clin Exp Dermatol. 2011;36(3):248–54. https://doi.org/10.1111/j.1365-2230.2010.03960.x.CrossRefPubMed

45.

Li DG, Xia FD, Khosravi H, Dewan AK, Pallin DJ, Baugh CW, et al. Outcomes of early dermatology consultation for inpatients diagnosed with cellulitis. JAMA Dermatol. 2018;154(5):537–43. https://doi.org/10.1001/jamadermatol.2017.6197.CrossRefPubMedPubMedCentral

46.

Ko LN, Garza-Mayers AC, St John J, Strazzula L, Vedak P, Shah R, et al. Effect of dermatology consultation on outcomes for patients with presumed cellulitis: a randomized clinical trial. JAMA Dermatol. 2018;154(5):529–36. https://doi.org/10.1001/jamadermatol.2017.6196.CrossRefPubMedPubMedCentral

47.

• Zakaria A, Maurer T, Su G, Amerson E. Impact of teledermatology on the accessibility and efficiency of dermatology care in an urban safety-net hospital: a pre-post analysis. J Am Acad Dermatol. 2019;81(6):1446–52. https://doi.org/10.1016/j.jaad.2019.08.016. Powerful retrospective analysis which indicates that teledermatology is efficient by a number of metrics.CrossRefPubMed

48.

McKoy K, Antoniotti NM, Armstrong A, et al. Practice guidelines for teledermatology. Telemed J E Health. 2016;22(12):981–90. https://doi.org/10.1089/tmj.2016.0137.CrossRefPubMed

49.

Wanat KA, Newman S, Finney KM, Kovarik CL, Lee I. Teledermatology education: current use of teledermatology in US residency programs. J Grad Med Educ. 2016;8(2):286–7. https://doi.org/10.4300/jgme-d-16-00041.1.CrossRefPubMedPubMedCentral

50.

Korman AM, Kroshinsky D, Raff AB, Mostaghimi A, Micheletti RG, Rosenbach M, et al. A survey-based study of diagnostic and treatment concordance in standardized cases of cellulitis and pseudocellulitis via teledermatology. J Am Acad Dermatol. 2020;82(5):1221–3. https://doi.org/10.1016/j.jaad.2019.09.084.CrossRefPubMed

51.

Strazzula L, Cotliar J, Fox LP, Hughey L, Shinkai K, Gee SN, et al. Inpatient dermatology consultation aids diagnosis of cellulitis among hospitalized patients: a multi-institutional analysis. J Am Acad Dermatol. 2015;73(1):70–5. https://doi.org/10.1016/j.jaad.2014.11.012.CrossRefPubMed

52.

Khosravi H, Nekooie B, Moorhead A, English JC 3rd. Inpatient teledermatology improves diagnostic accuracy and management of leg ulcers in hospitalized patients. Am J Clin Dermatol. 2021;22(5):735–7. https://doi.org/10.1007/s40257-021-00621-8.CrossRefPubMedPubMedCentral

53.

Khosravi H, Nekooie MB, Moorhead A, English JC 3rd. Inpatient teledermatology improves diagnostic accuracy and management of erythroderma in hospitalized patients. Clin Exp Dermatol. 2021;46(8):1555–7. https://doi.org/10.1111/ced.14807.CrossRefPubMed

54.

Ortiz C, Khosravi H, Kettering C, Moorhead A, English JC 3rd. Concordance data for inpatient asynchronous eDermatology consultation for immunobullous disease, zoster, and vasculitis. J Am Acad Dermatol. 2021. https://doi.org/10.1016/j.jaad.2021.03.048.CrossRefPubMed

55.

Weinkle A, Pettit C, Jani A, Keller J, Lu Y, Malachowski S, et al. Distinguishing Stevens-Johnson syndrome/toxic epidermal necrolysis from clinical mimickers during inpatient dermatologic consultation–a retrospective chart review. J Am Acad Dermatol. 2019;81(3):749–57. https://doi.org/10.1016/j.jaad.2019.05.061.CrossRefPubMed

56.

Haynes D, Hammer P, Malachowski SJ, Kaffenberger B, Yi JS, Vera N, et al. Characterisation and diagnosis of ulcers in inpatient dermatology consultation services: a multi-centre study. Int Wound J. 2019;16(6):1440–4. https://doi.org/10.1111/iwj.13211.CrossRefPubMedPubMedCentral

57.

Accreditation Council for Graduate Medical Education: ACGME Program Requirements for GraduateMedical Education in Dermatology. https://www.acgme.org/. Accessed 13 Jan 2022.

58.

Boyers LN, Schultz A, Baceviciene R, Blaney S, Marvi N, Dellavalle RP, et al. Teledermatology as an educational tool for teaching dermatology to residents and medical students. Telemed J E Health. 2015;21(4):312–4. https://doi.org/10.1089/tmj.2014.0101.CrossRefPubMedPubMedCentral

59.

Zakaria A, Miclau TA, Maurer T, Leslie KS, Amerson E. Cost minimization analysis of a teledermatology triage system in a managed care setting. JAMA Dermatol. 2021;157(1):52–8. https://doi.org/10.1001/jamadermatol.2020.4066.CrossRefPubMed

60.

Azfar RS, Lee RA, Castelo-Soccio L, Greenberg MS, Bilker WB, Gelfand JM, et al. Reliability and validity of mobile teledermatology in human immunodeficiency virus-positive patients in Botswana: a pilot study. JAMA Dermatol. 2014;150(6):601–7. https://doi.org/10.1001/jamadermatol.2013.7321.CrossRefPubMedPubMedCentral

61.

U.S. Centers for Medicare and Medicaid Services: Search the Physician Fee Schedule. https://www.cms.gov/medicare/physicianfeeschedule/searchY=0&T=4&HT=2&CT=2&H1=99441&H2=99452&C=64&M=5. Accessed 20 December 2021.

62.

Interstate Medical Licensure Compact Commission: U.S. State Participation in the Compact. https://www.imlcc.org/. 22 December 2021.

63.

American Academy of Professional Coders: CPT Codes Lookup. https://www.aapc.com/codes/cpt-codes-range/. 20 December 2021.

64.

AUGS Coding and Reimbursement Committee: Telehealth Services. https://www.augs.org/assets/1/6/AUGS_Coding_Fact_Sheet_Telehealth_2019.pdf. 24 January 2022.

Titel: Inpatient Teledermatology: a Review
verfasst von: Joseph Mocharnuk
Trevor Lockard
Corey Georgesen
Joseph C English
Publikationsdatum: 02.04.2022
Verlag: Springer US
Erschienen in: Current Dermatology Reports / Ausgabe 2/2022
Elektronische ISSN: 2162-4933
DOI: https://doi.org/10.1007/s13671-022-00360-x

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Dermatologie

Isotretinoin: Risiko für schwere Laboranomalien „marginal erhöht“

08.05.2024 Akne Nachrichten

Die Aknetherapie mit Isotretinoin kann einen Anstieg von Leberenzymen und Blutfetten verursachen. Das Risiko für schwere Störungen ist laut einer Forschungsgruppe der Universität Lübeck aber nur marginal erhöht und auf einen engen Zeitraum konzentriert.

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Inpatient Teledermatology: a Review

Abstract

Purpose of Review

Recent Findings

Summary

Leitlinien kompakt für die Dermatologie

Neu im Fachgebiet Dermatologie

Isotretinoin: Risiko für schwere Laboranomalien „marginal erhöht“

Darf man die Behandlung eines Neonazis ablehnen?

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

Update Dermatologie

Springer Medizin

Abstract

Purpose of Review

Recent Findings

Summary

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2022

Irritant Contact Dermatitis — a Review

Social Media as a Medium for Dermatologic Education

Neutrophilic Dermatoses: a Clinical Update

Sporotrichosis: a Comprehensive Review on Recent Drug-Based Therapeutics and Management

Applications of Stem Cell Therapy and Adipose-Derived Stem Cells for Skin Repair

Novel Diagnostic Technologies and Therapeutic Approaches Targeting Chronic Wound Biofilms and Microbiota

Leitlinien kompakt für die Dermatologie

Neu im Fachgebiet Dermatologie

Isotretinoin: Risiko für schwere Laboranomalien „marginal erhöht“

Darf man die Behandlung eines Neonazis ablehnen?

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Endlich: Zi zeigt, mit welchen PVS Praxen zufrieden sind

Update Dermatologie