Site Under Construction

Teledermatology at a tertiary government hospital in Davao City during the COVID-19 pandemic: a retrospective descriptive study

Anna Cristina L. Cuenca, MD, DPDS, Lalaine R. Visitacion, MD, FPDS, Jen-Christina Lourdes Q. Segovia, MD

Abstract

Introduction

Telemedicine is the practice of remote consultations that utilize computer-mediated communication. Given the visual nature of dermatology, it is most well-suited to adopt telecommunication practices. This enables remote medical care during public health emergencies like the current COVID-19 pandemic; limiting the risk of exposure for both patients and doctors alike.

 

Objectives

This study aimed to describe the demographic and clinical profile of teledermatology patients from April to August 2020. Data were also compared with face-to-face consultations during the same period in 2019 in order to establish whether telemedicine can be a viable and reliable substitute to face-to-face consultations during a pandemic.

Methods

We retrospectively analyzed chart data during a 5-month period in 2020; wherein the number of online consultations were observed to be the highest. We noted demographic and clinical features and compared some of these data to those obtained in the same period in 2019.

Results

A total of 1,632 patients were seen via teledermatology in 2020 versus 7,219 face-to-face patients in 2019. Mean age for both groups were 26.59 and 36.89 respectively. Most patients in both years were from Davao. However, there was an increase in consults from other regions in 2020. Overall, the majority of cases for both periods were non-urgent inflammatory conditions.

Conclusion

This study showed that providing remote dermatologic care is now possible with the advent of technology even during a pandemic. Teledermatology may serve as an effective adjunct to traditional consultations.

References

  1. Tensen E, van der Heijden JP, Jaspers MW, Witkamp L. Two Decades of Teledermatology: Current Status and Integration in National Healthcare Systems. Curr Dermatol Rep. 2016; 5:96-104. doi: 10.1007/s13671-016-0136-7.
  2. Flodgren G, Rachas A, Farmer AJ, et.al. Interactive telemedicine: eff ects on professional practice and health care outcomes. Cochrane Database Syst Rev. 2015 Sep 7; 2015(9):CD002098. doi: 10.1002/14651858.CD002098.pub2.
  3. World Health Organization. Recommendations on Digital Interventions for Health System Strengthening. https://apps.who.int/iris/bitstream/handlehttps://apps.who.int/iris/bitstream/handle/10665/311941/9789241550505-eng.pdf?ua=1. Published 2019. Accessed 9 July 2020.
  4. World Health Organization. Telemedicine: Opportunities and Developments in Member States. World Health Organization. https://www.who.int/goe/publications/goe_telemedicine_2010.pdf. Published 2010. Accessed 9 July 2020.
  5. Kwatra SG, Sweren RJ, Grossberg AL. Dermatology practices as vectors for COVID-19 transmission: A call for immediate cessation of nonemergent
    dermatology visits. J Am Acad Dermatol [Internet]. 2020 May 01 [2020 July 11]; 82(5):e179-e180. doi:10.1016/j.jaad.2020.03.037.
  6. Warshaw EM, Hillman YJ, Greer NL, et.al. Teledermatology for diagnosis and management of skin conditions: a systematic review. J Am Acad Dermatol. 2011 Apr; 64(4):759-72. doi: 10.1016/j.jaad.2010.08.026.
  7. 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 Dec 2; 14(12):e0225479. doi: 10.1371/journal.pone.0225479.
  8. 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(12):e28687. doi: 10.1371/journal.pone.0028687.
  9. Lee, I., Kovarik, C., Tejasvi, T., Pizarro, M., and Lipoff, J. Telehealth: Helping your patients and practice survive and thrive during the COVID-19 crisis with rapid quality implementation. J Am Acad Dermatol. 2020; 82(5): 1213-1214. https://doi.org/10.1016/j.jaad.2020.03.052.
  10. Interagency Task Force for the management of emerging infectious diseases [Internet]. Philippines: Official gazette; c2020 [cited 2021 October 2]. Available from https://www.offi cialgazette.gov.ph/downloads/2020/07jul/20200817-IATFRESOLUTION-NO-64.pdf
  11. Almathami HKY, Win KT, Vlahu-Gjorgievska E. Barriers and Facilitators That influence Telemedicine-Based, Real-Time, Online Consultation at Patients’ Homes: Systematic Literature Review. J Med Internet Res. 2020 Feb 20; 22(2):e16407. doi: 10.2196/16407.
  12. Hoffman DA. Increasing access to care: telehealth during COVID-19. J Law Biosci. 2020; 7(1):lsaa043. doi:10.1093/jlb/lsaa043.
  13. Cimperman M, Brenčič MM, Trkman P, Stanonik Mde L. Older adults’ perceptions of home telehealth services. Telemed J E Health. 2013; 19(10):786-90. doi: 10.1089/tmj.2012.0272.
  14. Sreeramareddy CT, Shankar RP, Sreekumaran BV, et al. Care seeking behaviour for childhood illness–a questionnaire survey in western Nepal. BMC International Health and Human Rights. 2006 May; 6:7. DOI: 10.1186/1472-698x-6-7.
  15. Thompson AE, Anisimowicz Y, Miedema B, et.al. The infl uence of gender and other patient characteristics on health care-seeking behaviour: a QUALICOPC study. BMC Fam Pract. 2016 March; 17:38. doi: 10.1186/s12875-016-0440-0.
  16. Elsner P. Teledermatology in the times of COVID-19 – a systematic review. J Dtsch Dermatol Ges. 2020 Aug; 18(8):841-845. doi: 10.1111/ddg.14180.
  17. Fluhr JW, Gueguen A, Legoupil D, et.al. Teledermatology in Times of COVID-19 Confi nement: Comparing Patients’ and Physicians’ Satisfaction by the Standardized Brest Teledermatology Questionnaire. Dermatology. 2021 Feb 10; 237(2):1-6. doi: 10.1159/000514029.
  18. Giavina-Bianchi M, Santos AP, Cordioli E. Teledermatology reduces dermatology referrals and improves access to specialists. EClinicalMedicine. 2020 Nov; 29-30:100641. doi.org/10.1016/j.eclinm.2020.100641.

REquesting Permission

Teledermatology at a tertiary government hospital in Davao City during the COVID-19 pandemic: a retrospective descriptive study