Original articleImpact of dermatology eConsults on access to care and skin cancer screening in underserved populations: A model for teledermatology services in community health centers
Section snippets
Study design
This study used a descriptive retrospective cohort design and was reviewed and approved by the Institutional Review Board of Community Health Center Inc. There were 2 comparison groups: patients referred to dermatology during the 6 months before implementation of eConsults and patients referred during the 6-month period after eConsult implementation. The post-eConsult group was further subdivided into 2 subgroups: patients send to eConsult and patients directly sent for a face-to-face (F2F)
Referral request outcomes
Fig 1 shows the outcome for all 2385 dermatology consult requests. There were 1258 consults in the pre-eConsult period and 1127 in the post-eConsult period. Patients in these 2 groups were similar, with minor but significant differences in age and race (Table I). For the pre-eConsult group, 744 patients (59%) received an appointment, and only 139 (11%) patients had a confirmed visit with a dermatologist. Of 1127 consults requested in the post-eConsult period, 628 (56%) were for a F2F visit,
Discussion
This study demonstrates that significant improvement in access to dermatologic care can be obtained when eConsults are implemented in a safety net health system. Consistent with previous studies,7, 8, 18, 19, 20 the intervention resulted in marked improvement to access. However, unlike previous work, these findings demonstrate how eConsults perform on a larger scale, in a nonclosed system where providers had free choice whether to use the system or not, and where the reviewing dermatologists
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Ms Naka and Dr Lu contributed equally to this work.
Funding sources: Supported by the Jesse B. Cox Charitable Trust.
Conflicts of interest: None declared.