TELEDERMATOLOGY

Teledermatology is the practice of using available communication and information technology for dermatology consultations. Because it is a visually based specialty, dermatology is well suited for telemedicine.¹

Teledermatology is particularly useful, as studies have shown that health professionals other than a dermatologist are poor at diagnosing skin problems (20% of general practitioners are unable to diagnose twenty of the most common dermatological diseases).²

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There are two modes of teledermatology consultations:^{3 4}

• Store and forward teledermatolgy: This describes a method of sharing information in a time and place-dependent manner. It makes use of digital images, which are acquired, with the use of a computer (store), and clinical information, both of which are then transmitted to the intended recipient (forward).
• Video teleconferencing (VTC): this method makes use of communication systems that provide synchronous video and audio transmission for a live interactive consultation between a patient and a consultant dermatologist. Such systems range from the simple use of a digital camera attached to a desktop computer to expensive video conferencing rooms.

Both methods are not without their advantages and disadvantages. Advantages of store and forward teledermatology include not only its practicality and low cost but also the fact there is no need for a consulting physician at the same time as a forwarding physician and patient. Its disadvantage is that the consulting physician can only work with the images provided and cannot ask for more clinical information for aiding diagnosis.

The main advantage of video conferencing is that it can mimic a face-to-face consultation and allows for the consulting physician to ask the referring physician and patient clinical questions. Its disadvantages are its expensive cost and the fact that it requires coordination between the physicians and patient.

Although the use of teledermatology is spreading; there are some obstacles to its growth.⁵ They include

• Lack of good outcomes.
  
  
• Store and forward teledermatology is not reimbursable.
  
  
• Interstate medical licensing restrictions within the US.
  
  
• Limited technological support personnel.
  
  
• Resistance of traditionally educated physicians.
  
  
• Medicolegal issues on liability such as lack of standards or laws governing the practising of teledermatology.

References

1. Pak, H. S. Teledermatology and teledermatopathology. Semin Cutan Med Surg. 2002 Sep;21(3):179-89

2. Jambusaria, Anokhi. 14^TH January 1999. Teledermatology. http://members.tripod.com/~Telemedicine/teledermatology.htm (25^TH September 2003)

3. Whited, J. D. Teledermatology. Current status and future directions. Am J Clin Dermatol. 2001;2(2):59-64.

4. Burg, Gunter. Bader, Urs. Pak, Hon. 17^TH July 2001. [WWW] Store-and-Forward Teledermatology. http://www.emedicine.com/derm/topic560.htm (25^TH September 2003).

5. IEEE. 22^ND April 1996 [WWW] Enhanced application of telemedicine. http://www.ieeeusa.org/documents/FORUM/LIBRARY/PAPERS/licensing.html (25^TH September 2003).

• Interactive Teledermatology
  An article by Charles Phillips MD on the eMedicine website.
  http://www.emedicine.com/derm/topic567.htm

• Teledermatology
  An article by Joseph C Kvedar, MD on the eMedicine website.
  http://www.emedicine.com/derm/topic527.htm

• Skin care from a distance
  An article by Rod P. Fajardo III
  http://www.up.edu.ph/skincare.htm

QUICK LINKS

International Medical Informatics Association

American Medical Informatics Association

UK Health Informatics Society

British Computer Society Health Informatics Committee

European Federation for Medical Informatics

American Nursing Informatics Association

American Telemedicine Association

Last Updated: 10 August 2006.