NYMC Faculty Publications
Implementing and Optimizing Inpatient Access to Dermatology Consultations via Telemedicine: An Experiential Study
Author Type(s)
Faculty
DOI
10.1089/tmj.2019.0267
Journal Title
Telemedicine Journal and e-Health
First Page
68
Last Page
73
Document Type
Article
Publication Date
1-2021
Department
Medicine
Second Department
Anesthesiology
Abstract
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.
Recommended Citation
Dhaduk, K., Miller, D. M., Schliftman, A., Athar, A., Al Aseri, Z., Echevarria, A., Hale, B., Scurlock, C., & Becker, C. (2021). Implementing and Optimizing Inpatient Access to Dermatology Consultations via Telemedicine: An Experiential Study. Telemedicine Journal and e-Health, 27 (1), 68-73. https://doi.org/10.1089/tmj.2019.0267