Teledermatologie: Fluch oder Segen?

Zusammenfassung

Teledermatologische Dienste haben sich insbesondere während der COVID-19-Pandemie als Alternative zu „Echt“visiten verbreitet. Der Mangel an Dermatologen und die Möglichkeit einer präzisen Diagnose auch bei unterversorgten Regionen macht diese Alternative für alle Beteiligten besonders attraktiv. Trotzdem ist der Bedarf an Schulungen des Personals und der Anwender hoch. Ebenfalls können Implementierungs-, Instandhaltungs- und Wartungskosten der notwendigen Ausrüstung und die Heterogenität der unterschiedlichen Anbieter nachteilig für Patient und Arzt sein. In diesem Artikel werden wesentliche Vorteile und Nachteile der Teledermatologie zusammengefasst.

Abstract

Teledermatologic services appeared as an effective alternative to conventional visits, especially during the COVID-19 pandemic. The lack of qualified dermatologists and diagnostic efficacy, in combination with the lack of care in rural regions makes teledermatology appealing both for patient and doctors. Despite this, the need for specialized training of the personnel and the user is high and the costs for implementation and maintenance of this technology are not negligible. Moreover, the heterogeneity of the providers could present itself as strenuous for patients and doctors. In this short review we summarize the advantages and disadvantages of teledermatology.

Publication History

Article published online:
22 February 2022

• Literatur

• 1 Elsner P. Teledermatology in the times of COVID-19 – a systematic review. J Dtsch Dermatol Ges 2020; 18: 841-845
• 2 Maintaining essential health services: operational guidance for the COVID-19 context interim guidance. Accessed April 4, 2021: https://www.who.int/publications/i/item/WHO-2019-nCoV-essential-health-services-2020
• 3 Gaffney R, Rao B. Global teledermatology. Glob Dermatology 2015; 2: 209-214
• 4 Weinberg J, Kaddu S, Gabler G. et al. The African Teledermatology Project: Providing access to dermatologic care and education in sub-Saharan Africa. Pan Afr Med J 2009; 3: 16
• 5 Coustasse A, Sarkar R, Abodunde B. et al. Use of Teledermatology to Improve Dermatological Access in Rural Areas. Telemed e-Health 2019; 25: 1022-1032
• 6 Pearlman RL, Le PB, Brodell RT. et al. Evaluation of patient attitudes towards the technical experience of synchronous teledermatology in the era of COVID-19. Arch Dermatol Res 2021; 1-4
• 7 Trettel A, Eissing L, Augustin M. Telemedicine in dermatology: findings and experiences worldwide – a systematic literature review. J Eur Acad Dermatology Venereol 2018; 32: 215-224
• 8 Fabbrocini G, De Vita V, Pastore F. et al. Teledermatology: From prevention to diagnosis of nonmelanoma and melanoma skin cancer. Int J Telemed Appl 2011; 2011: 125762
• 9 Andrees V, Klein TM, Augustin M. et al. Live interactive teledermatology compared to in-person care – a systematic review. J Eur Acad Dermatology Venereol 2020; 34: 733-745
• 10 Nami N, Giannini E, Burroni M. et al. Teledermatology: State-of-the-art and future perspectives. Expert Rev Dermatol 2012; 7: 1-3
• 11 Giavina-Bianchi M, Sousa R, Cordioli E. Part I: Accuracy of Teledermatology in Inflammatory Dermatoses. Front Med 2020; 7: 585792
• 12 Lee JJ, English JC. Teledermatology: A Review and Update. Am J Clin Dermatol 2018; 19: 253-260
• 13 Challenges of Teledermatology: Lessons Learned During COVID-19 Pandemic. Accessed April 3, 2021: https://escholarship.org/uc/item/7193305r
• 14 Giavina Bianchi M, Santos AP, Cordioli E. The majority of skin lesions in pediatric primary care attention could be managed by Teledermatology. PLoS One 2019; 14: e0225479
• 15 Elsner P, Bauer A, Diepgen TL. et al. Position paper: Telemedicine in occupational dermatology – Current status and perspectives. J Dtsch Dermatol Ges 2018; 16: 969-974
• 16 Chuchu N, Dinnes J, Takwoingi Y. et al. Teledermatology for diagnosing skin cancer in adults. Cochrane Database Syst Rev 2018; 12: CD013193
• 17 Clark AK, Bosanac S, Ho B. et al. Systematic review of mobile phone-based teledermatology. Arch Dermatol Res 2018; 310: 675-689
• 18 Giavina-Bianchi M, Santos AP, Cordioli E. Teledermatology reduces dermatology referrals and improves access to specialists. EClinicalMedicine 2020; 29-30
• 19 O’Connor DM, Jew OS, Perman MJ. et al. Diagnostic accuracy of pediatric teledermatology using parent-submitted photographs a randomized clinical trial. JAMA Dermatology 2017; 153: 1243-1248
• 20 Pasquali P, Sonthalia S, Moreno-Ramirez D. et al. Teledermatology and its Current Perspective. Indian Dermatol Online J 2020; 11: 12-20
• 21 Zhai Y, Wang Y, Zhang M. et al. From Isolation to Coordination: How Can Telemedicine Help Combat the COVID-19 Outbreak?. medRxiv 2020;
• 22 Costello CM, Cumsky HJL, Maly CJ. et al. Improving Access to Care through the Establishment of a Local, Teledermatology Network. Telemed e-Health 2020; 26: 935-940
• 23 Brown EM. The Ontario Telemedicine Network: A case report. Telemed e-Health 2013; 19: 373-376
• 24 Zakaria A, Maurer T, Su G. et al. Impact of teledermatology on the accessibility and efficiency of dermatology care in an urban safety-net hospital: A pre-post analysis. J Am Acad Dermatol 2019; 81: 1446-1452
• 25 Rothstein BE, Gonzalez J, Cunningham K. et al. Direct and indirect patient costs of dermatology clinic visits and their impact on access to care and provider preference. Cutis 2017; 100: 405-410
• 26 Datta SK, Warshaw EM, Edison KE. et al. Cost and utility analysis of a store-and-forward teledermatology referral system: A randomized clinical trial. JAMA Dermatology 2015; 151: 1323-1329
• 27 Gordon AS, Adamson WC, DeVries AR. Virtual visits for acute, nonurgent care: A claims analysis of episode-level utilization. J Med Internet Res 2017; 19: e35
• 28 van der Heijden JP, Thijssing L, Witkamp L. et al. Accuracy and reliability of teledermatoscopy with images taken by general practitioners during everyday practice. J Telemed Telecare 2013; 19: 320-325
• 29 Whited JD. Teledermatology. Med Clin North Am 2015; 99: 1365-1379
• 30 Tensen E, van der Heijden JP, Jaspers MWM. et al. Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems. Curr Dermatol Rep 2016; 5: 96-104
• 31 Vedire K, Joselow AL, Markham CM. et al. Teledermatology-directed surgical care is safe and reduces travel. J Telemed Telecare 2016; 22: 121-126
• 32 Whited JD, Hall RP, Simel DL. et al. Reliability and accuracy of dermatologists’ clinic-based and digital image consultations. J Am Acad Dermatol 1999; 41: 693-702
• 33 High WA, Houston MS, Calobrisi SD. et al. Assessment of the accuracy of low-cost store-and-forward teledermatology consultation. J Am Acad Dermatol 2000; 42: 776-783
• 34 Yang X, Barbieri JS, Kovarik CL. Cost analysis of a store-and-forward teledermatology consult system in Philadelphia. J Am Acad Dermatol 2019; 81: 758-764
• 35 Snoswell C, Finnane A, Janda M. et al. Cost-effectiveness of store-and-forward teledermatology: A systematic review. JAMA Dermatology 2016; 152: 702-708
• 36 Sood A, Granick MS, Trial C. et al. The role of telemedicine in wound care: A review and analysis of a database of 5,795 patients from a mobile wound-healing center in Languedoc-Roussillon, France. Plast Reconstr Surg 2016; 138: 248S-256S
• 37 Romero Aguilera G, Cortina De La Calle P, Vera Iglesias E. et al. Interobserver reliability of store-and-forward teledermatology in a clinical practice setting. Actas Dermosifiliogr 2014; 105: 605-613
• 38 Moreno-Ramírez D, Ferrándiz L. A 10-year history of teledermatology for skin cancer management. JAMA Dermatology 2015; 151: 1289-1290
• 39 Krensel M, Augustin M, Rosenbach T. et al. Wartezeiten und Behandlungsorganisation in der Hautarztpraxis. J Dtsch Dermatol Ges 2015; 13: 812-814
• 40 Börve A, Dahlén Gyllencreutz J, Terstappen K. et al. Smartphone teledermoscopy referrals: A novel process for improved triage of skin cancer patients. Acta Derm Venereol 2015; 95: 186-190
• 41 Morton CA, Downie F, Auld S. et al. Community photo-triage for skin cancer referrals: An aid to service delivery. Clin Exp Dermatol 2011; 36: 248-254
• 42 Kahn E, Sossong S, Goh A. et al. Evaluation of skin cancer in Northern California kaiser permanente’s store-and-forward teledermatology referral program. Telemed e-Health 2013; 19: 780-785
• 43 TeleDerm: Rapid help from a dermatologist via teleconsultation – Healthcare industry. https://www.gesundheitsindustrie-bw.de/en/article/news/telederm-rapid-help-from-a-dermatologist-via-teleconsultation
• 44 Armstrong AW, Wu J, Kovarik CL. et al. State of teledermatology programs in the United States. J Am Acad Dermatol 2012; 67: 939-944
• 45 Brinker TJ, Hekler A, Von Kalle C. et al. Teledermatology: Comparison of store-and-forward versus live interactive video conferencing. J Med Internet Res 2018; 20: e11871
• 46 Hjelm NM. Benefits and drawbacks of telemedicine. J Telemed Telecare 2005; 11: 60-70
• 47 Wootton R, Loane MA, Bloomer SE. et al. Multicentre randomised control trial comparing real time teledermatology with conventional outpatient dermatological care: Societal cost-benefit analysis. Br Med J 2000; 320: 1252-1256
• 48 Gupta R, Ibraheim MK, Doan HQ. Teledermatology in the wake of COVID-19: Advantages and challenges to continued care in a time of disarray. J Am Acad Dermatol 2020; 83: 168-169
• 49 Shapiro M, James WD, Kessler R. et al. Comparison of skin biopsy triage decisions in 49 patients with pigmented lesions and skin neoplasms: Store-and-forward teledermatology vs face-to-face dermatology. Arch Dermatol 2004; 140: 525-528
• 50 Blum A, Hofmann-Wellenhof R, Luedtke H. et al. Value of the clinical history for different users of dermoscopy compared with results of digital image analysis. J Eur Acad Dermatology Venereol 2004; 18: 665-669
• 51 Zink A, Kolbinger A, Leibl M. et al. The value of teledermatology using a mobile app compared to conventional dermatology. Eur J Dermatology 2017; 27: 429-431
• 52 Coates SJ, Kvedar J, Granstein RD. Teledermatology: From historical perspective to emerging techniques of the modern era: Part I: History, rationale, and current practice. J Am Acad Dermatol 2015; 72: 563-574
• 53 Fenton A, Elliott E, Shahbandi A. et al. Analysis of availability, types, and implementation of teledermatology services during COVID-19. J Am Acad Dermatol 2020; 83: 958-959
• 54 Sondermann W, von Kalle C, Utikal JS. et al. External scientific evaluation of the first teledermatology app without direct patient contact in Germany (Online Dermatologist–AppDoc). Hautarzt 2020; 71: 887-897
• 55 Schuster B, Ziehfreund S, Tizek L. et al. Is the Bavarian Population Open for Teledermatology? A Cross-Sectional Study in Rural and Urban Regions of Bavaria, Germany. Gesundheitswesen 2021; 83: 53-58
• 56 disadvantages of data protection act in health and social care. Seers. Verfügbar unter (Stand 09.06.2021): https://seersco.com/articles/tag/disadvantages-of-data-protection-act-in-health-and-social-care/
• 57 Lee K, Finnane A, Soyer HP. Recent trends in teledermatology and teledermoscopy. Dermatol Pract Concept 2018; 8: 214-223
• 58 Armstrong AW, Kwong MW, Ledo L. et al. Practice models and challenges in teledermatology: A study of collective experiences from teledermatologists. PLoS One 2011; 6: e28687
• 59 Brauns HJ, Loos W. Telemedizin in Deutschland: Stand – Hemmnisse – Perspektiven. Bundesgesundheitsblatt – Gesundheitsforsch – Gesundheitsschutz 2015; 58: 1068-1073
• 60 Hummers-Pradier E, Bleidorn J, Schmiemann G. et al. General practice-based clinical trials in Germany – a problem analysis. Trials 2012; 13: 205
• 61 Rubegni P, Nami N, Cevenini G. et al. Geriatric teledermatology: store-and-forward vs. face-to-face examination. J Eur Acad Dermatology Venereol 2011; 25: 1334-1339
• 62 Silliman RA. Caring for the frail older patient – The doctor – patient – family caregiver relationship. J Gen Intern Med 1989; 4: 237-241
• 63 Villa L, Matz O, Olaciregui Dague K. et al. The assessment of dermatological emergencies in the emergency department via telemedicine is safe: a prospective pilot study. Intern Emerg Med 2020; 15: 1275-1279