Teledermatology programs in the United States have evolved over the past several decades. No systematic survey of teledermatology programs in the United States is available in peer-reviewed literature.
To provide up-to-date information regarding the state of teledermatology programs in the United States.
Active U.S. teledermatology programs were surveyed in 2011 with regards to practice models, clinical volume, and payment methods. These findings were compared with those from 2003.
By January 2012, 37 teledermatology programs were active in the United States. Store-and-forward teledermatology was the most frequent delivery modality offered by 30 (81%) of the programs. The majority of the programs were based at academic institutions (49%), followed by Veterans Administration hospitals (27%), private practice (16%), and health maintenance organizations (HMOs) (8%). The majority of programs (67%) provided services to their home state only, whereas the rest also served additional U.S. states or abroad. The median number of consultations per program was 309 (range, 5-6500) in 2011. The most frequent payer sources were private payers, followed by self-pay, Medicaid, Medicare, and HMOs. Since 2003, with the confirmed discontinuation of 24 previously active programs, the total number of active teledermatology programs in 2011 was 60% of that in 2003. However, the annual consult volume per program nearly doubled for the sustainable programs in 2011.
Itemized billing information was not uniformly available from all programs.
The turnover in teledermatology programs is relatively constant, with an increase in consult volume for sustainable programs. Store-and-forward is the dominant modality of delivery, while hybrid technology model is emerging.
"International comparisons regarding telemedicine activity can also be useful in terms of clinical specialties. In a recent systematic survey of the state of teledermatology in the United States, the median number of teleconsultations per site in 2011 was 3,650 and 1,200 for health maintenance organizations (HMOs) and government-associated programs (38), respectively, a higher use compared to routine teledermatology in Norwegian hospitals (Table 6). "
[Show abstract][Hide abstract] ABSTRACT: Background:
Telemedicine appears to be ready for wider adoption. Although existing research evidence is useful, the adoption of routine telemedicine in healthcare systems has been slow.
We conducted a study to explore the current use of routine telemedicine in Norway, at national, regional, and local levels, to provide objective and up-to-date information and to estimate the potential for wider adoption of telemedicine. Design : A top-down approach was used to collect official data on the national use of telemedicine from the Norwegian Patient Register. A bottom-up approach was used to collect complementary information on the routine use of telemedicine through a survey conducted at the five largest publicly funded hospitals.
Results show that routine telemedicine has been adopted in all health regions in Norway and in 68% of hospitals. Despite being widely adopted, the current level of use of telemedicine is low compared to the number of face-to-face visits. Examples of routine telemedicine can be found in several clinical specialties. Most services connect different hospitals in secondary care, and they are mostly delivered as teleconsultations via videoconference.
Routine telemedicine in Norway has been widely adopted, probably for geographical reasons, as in other settings. However, the level of use of telemedicine in Norway is rather low, and it has significant potential for further development as an alternative to face-to-face outpatient visits. This study is a first attempt to map routine telemedicine at regional, institutional, and clinical levels, and it provides useful information to understand the adoption of telemedicine in routine healthcare and to measure change in future updates.
Global Health Action 01/2014; 7(1):22801. DOI:10.3402/gha.v7.22801 · 1.93 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
Mobile teledermatology applications have enabled increased patient access to dermatologic care. For groups interested in starting a mobile teledermatology program, selection of the appropriate application can be challenging. Having pretested evaluation criteria allows for efficient, systematic assessment of mobile teledermatology applications and identification of features important for comparison. The primary aim of this study is to determine a framework for evaluation of mobile teledermatology applications and to compare two major mobile teledermatology applications available in the United States using the proposed criteria.
Materials and methods:
We incorporated previous teledermatology application evaluation criteria and developed new evaluation criteria to reflect matters specific to the mobile platform. Through a systematic search, we identified two publicly available mobile teledermatology applications in the United States and applied the evaluation criteria.
The 13-point evaluation criteria encompass three major domains: (1) technical specifications, (2) user experience and workflow, and (3) integration and scalability. The evaluation criteria provided an effective way of assessing the two mobile teledermatology applications. Both AccessDerm version 1.0 (Vignet Corp., McLean, VA) and ClickMedix version 1.3 (ClickMedix LLC, Rockville, MD) were capable of managing consultations. These applications adopted different approaches to balancing image quality versus data transmission, managing follow-up patients, and enabling dialogue between providers.
Mobile teledermatology provides convenient and scalable means of providing specialty care. The creation of mobile application evaluation criteria offers a useful guide for assessing future mobile applications.
Telemedicine and e-Health 06/2013; 19(9). DOI:10.1089/tmj.2012.0234 · 1.67 Impact Factor
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