Danica Xie, John Sullivan
Aims: Dermatological complaints account for around one in ten emergency department (ED) visits, and up to 83% of dermatology consults do not require hospital admission. In Australia, telemedicine is one strategy to increase access to dermatologic care, especially in rural and remote communities. The main forms of teledermatology are store-and-forward and real-time teledermatology, characterised by referring clinicians asking the dermatology team for advice by sending clinical photos (or a combination of photos and short videos), or via videoconferencing respectively. As such, teledermatology is useful in ED’s, where barriers such as lack of dermatology on-call cover prevent timely communication and dermatological care. The current literature was reviewed to investigate the patient- and clinician-based utility of teledermatology in hospital ED’s.
Methods: Relevant studies were searched in Medline, PubMed Science Direct and Scopus electronic databases up to March 2022.
Results: Four studies including 660 patients were identified. All studies were based in the Australian healthcare system, including three store-and-forward and one real-time teledermatology study. The most common diagnoses were dermatitis/eczema (183 cases, 28%), infection (117 cases, 18%) and drug eruption (100 cases, 15%). Teledermatology confers up to 98% diagnostic agreement compared with in-person dermatology, and most services provided specialised advice within 2 h. Limited data exists on the extent of data security maintained throughout these processes.
Conclusions: Teledermatology is an accurate, efficient, and timely way to provide specialist dermatology advice to under-resourced emergency departments and communities. Care should be taken to ensure patient confidentiality is maintained during teledermatology communications.