Teledermatology: influence of zoning and education on a clinician's ability to observe peripheral lesions.

Teledermatology can benefit rural and remote communities, where specialist dermatological services may not be readily available. Regarding store-and- forward teledermatology, we hypothesized that the site of a lesion in an image (zoning) may influence a clinician's ability to observe target lesions, and that education on image viewing may improve use of this technology. We examined this by conducting both pre- and post-education studies. The education on image viewing consisted of a presentation on the outcome of the first study-survey on image viewing. The first study demonstrated that zoning influences a clinician's visual attention and that significant, concurrent lesions in the periphery may be missed. The second study demonstrated that brief education could produce a measurable change in observing peripheral lesions. These findings have medico-legal implications and suggest that further education in the use of such technology is necessary in order to optimize patient care and prevent potential errors.