Users and Nonusers of University-Based Dermatology Services Following a Teledermatology Encounter: A Retrospective Descriptive Analysis

Abstract

Objective: The aim of this study was to retrospectively describe hybrid technology teledermatology encounters performed by a statewide telehealth network. Consult outcomes were reviewed to describe the number of encounters that resulted in a visit to the university-based dermatology clinics and the features of those visits. Materials and Methods: Teledermatology encounters were reviewed to determine encounter volume and the proportion of encounters that resulted in a university-based dermatology clinic visit. Additional information collected included demographics, the reason for the visit, management recommendations, and clinical diagnoses. After identifying those consults that resulted in a dermatology clinic visit, we reviewed a random sample of teledermatology encounters that did not result in a university-based dermatology clinic visit for a descriptive comparison. Results: A total of 1,536 teledermatology encounters were completed by the network between 2001 and 2007. Of the 1,307 encounters reviewed, 56 patients were seen in the university-based dermatology clinic after the teledermatology encounter. The need for a procedure or clinic-based intervention was a reason for the visit in 79% of these encounters. When reviewing management recommendations, 46% of the patients who required a university-based clinic visit needed a procedural intervention compared with 8% of the group that did not need a clinic visit. Medical recommendations predominated in the telemedicine-only group (71%) compared with the clinic-based visit group (36%). Conclusions: Our study describes the features, such as demographics and case-mix, of users and nonusers of university-based dermatology clinics after teledermatology encounters that may be important considerations for future evaluations of teledermatology consult systems.