Optimizing Dermatological Care Triage in a Safety-Net Hospital: Retrospective Analysis of Diagnoses and In-Person Referrals.

Autor:	Shih A; From the Department of Dermatology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts., Riopelle A; From the Department of Dermatology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts., Ordan A; the Department of Dermatology, Boston Medical Center, Boston, Massachusetts., Sanchez S; the Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts., Bhawan J; From the Department of Dermatology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts., Lam CS; From the Department of Dermatology, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
Jazyk:	angličtina
Zdroj:	Southern medical journal [South Med J] 2024 Oct; Vol. 117 (10), pp. 577-581.
DOI:	10.14423/SMJ.0000000000001737
Abstrakt:	Objectives: Teledermatology is a cost-effective and efficient approach to delivering care and is particularly beneficial for patients with limited access to specialized services. Considering the rapid expansion of telehealth, it is crucial to focus on optimization. The purpose of our study was to evaluate the triaging of dermatologic care in an electronic consultation (e-consultation) service in a safety-net hospital. Methods: This was a 2-year retrospective review of a dermatology asynchronous store-and-forward e-consultation service. Results: A total of 1425 patients completed 1502 e-consultation. Of these e-consultations, 46% of the patients had Medicaid and 44% were Black or African American. The top three diagnoses were dermatitis unspecified, neoplasm of uncertain behavior, and acne/rosacea. Most (68%) were managed via e-consultation and did not require an in-person appointment. Children and adolescents were more likely to require an in-person appointment (74%) compared with adults (30%, P < 0.0001). Patients with a chief complaint of hair loss or skin lesion were more likely to require in-person evaluation (58% and 41%, respectively) compared with rash (24%) and acne (18%) ( P < 0.0001). There was no difference found in recommendations for in-person evaluation based on race, non-English-language preference, or insurance status. Conclusions: E-consultation services seem well suited for certain concerns, and underserved populations can be evaluated by teledermatology.
Databáze:	MEDLINE
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