Implementing and Optimizing Inpatient Access to Dermatology Consultations via Telemedicine: An Experiential Study.
- Resource Type
- Article
- Authors
- Dhaduk, Kartik; Miller, Daniel; Schliftman, Alan; Athar, Ammar; Al Aseri, Zohair Ahmed; Echevarria, Alison; Hale, Brian; Scurlock, Corey; Becker, Christian
- Source
- Telemedicine & e-Health. Jan2021, Vol. 27 Issue 1, p68-73. 6p.
- Subject
- *PATIENT satisfaction
*DERMATOLOGY
*TELEMEDICINE
*DIAGNOSIS
*HOSPITAL patients
*HOSPITAL care
- Language
- ISSN
- 1530-5627
Background/Introduction: In-house dermatology consultation services for hospitalized patients are not universally available in acute care hospitals. We encountered an unanticipated access gap for in-person dermatology consultations in our tertiary care hospital that routinely cares for complex high acuity patients with multiple comorbidities. To bridge this gap in specialist expertise in a timely manner, we expeditiously designed and implemented a telemedicine-supported inpatient dermatology consultation service. Methods: We conducted a retrospective review of 155 teledermatology consultations conducted between November 2017 and March 2019 as well as periodic prospective multidisciplinary process improvement meetings to optimize service-associated process maps and workflows. Results: Teledermatology consultations changed the working diagnosis of the primary team in 52.3% of cases and most commonly recommended medical management (61.9% of cases). In total 100% of patients accepted telemedicine support and rated their experience as positive. The first three periodic process improvement meetings led to significant improvements in teledermatology-related process maps and workflows. Discussion: Diagnostic concordance rates between the primary team and the teledermatologist were similar to those reported in the literature for in-person dermatology consultations. Important process improvements include establishing central responsibility of preparing and overseeing the consultation process, mandating the presence of a primary team representative during consultation and patient chart review by the teledermatologist before teleconsultation. Conclusion: Inpatient teledermatology consultation services can be instituted timely and continuously improved to reliably and effectively bridge access gaps, improve diagnostic accuracy and differentiate therapeutic approaches while maintaining patient satisfaction. [ABSTRACT FROM AUTHOR]