Teledermatologic consults via mobile phones invalidated, clarified, or enlarged an emergency physician’s diagnosis and management in 68% of 110 cases seen in the emergency department, based on data from an observational study published online May 7 in JAMA Dermatology.
"Easy access to a dermatologist helped ED physicians manage their skin problems," wrote Dr. Tu Anh Duong, who conducted the study while at the Hôpital Henri Mondor, Créteil, France, and her associates.
Management concordance between emergency physicians and dermatologists was high for diagnostic and specialist consultations within 24 hours, moderate for immediate hospitalization, and poor for patient discharge, the researchers noted (JAMA Dermatol. 2014 May 7 [doi:10.1001/jamadermatol.2013.7792]).
The study included 110 adults aged 18 years and older seen consecutively for dermatologic conditions at four French hospitals. The majority of the conditions were skin infections (28%) or eczema/urticaria (24%). In each case, an ED physician sent digital images and possible diagnoses to a dermatologist, and both physicians recorded their diagnoses and management choices. For 83 cases, the physicians participated in a videoconference, which improved diagnostic performance in 57 cases (69%) and invalidated photographic diagnoses in 8 cases (10%).
The findings confirm the convenience and effectiveness of using mobile devices for teledermatology services in the ED and suggest that that such devices be used for real-time communication between physicians after images are sent, the researchers said. However, "the use of mobile devices requires a functional high-speed telecommunication network, a secure protocol for image transfer, a reliable storage system, and some minimal organization," they added.
The study was funded by a research grant from the Société Française de Dermatologie. Mobile phones and communication costs were provided by the Société Française du Radiotéléphonie. Dr. Duong disclosed receiving a grant from Basilea Pharmaceutica for the first year of her PhD program.
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