| Autor: |
Ford AR; 1 Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California., Gibbons CM; 1 Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California., Torres J; 1 Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California., Kornmehl HA; 2 Department of Dermatology, Drexel University College of Medicine, Philadelphia, Pennsylvania., Singh S; 3 Department of Dermatology, University of California Davis School of Medicine, Sacramento, California., Young PM; 1 Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California., Chambers CJ; 3 Department of Dermatology, University of California Davis School of Medicine, Sacramento, California., Maverakis E; 3 Department of Dermatology, University of California Davis School of Medicine, Sacramento, California., Dunnick CA; 4 Department of Dermatology, University of Colorado School of Medicine, University of Colorado Denver, Aurora, Colorado., Armstrong AW; 1 Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California. |
| Abstrakt: |
Background: Many patients with chronic skin diseases lack regular access to dermatologists in the United States and suffer poor clinical outcomes. Introduction: We performed a 12-month randomized controlled trial to evaluate the impact of an online, collaborative connected health (CCH) model for psoriasis management on access to specialty care. Materials and Methods: The 300 enrolled patients were randomized to online or in-person care. We compared distance traveled as well as transportation and in-office waiting time between the two groups and obtained patient and provider perspectives on CCH. Results: At baseline, no differences existed between the groups in difficulties obtaining specialty care. Over 12 months, the mean (standard deviation [SD]) distance traveled to and from appointments was 174.8 (±577.4) km/person for the in-person group and 2.2 (±14.2) km/person for the online group ( p = 0.0003). The mean (SD) time spent on transportation and in-office waiting for in-person appointments was 4.0 (±4.5) h/person for the in-person group and 0.1 (±0.4) h/person for the online group ( p = 0.0001). Patients found CCH to be safe, accessible, equitable, efficient, effective, and patient-centered. Providers found CCH to be useful for providing psoriasis care. Discussion: The CCH model resulted in significantly less distance traveled as well as transportation and in-office waiting time compared to in-person care. Both patients and providers were highly satisfied with CCH. Conclusions: The CCH model resulted in increased access to specialty care and enabled patient-centered, safe, and effective management of psoriasis patients. |
