Adam R Ford1, Caitlin M Gibbons1, Josefina Torres1, Heather A Kornmehl2, Sanminder Singh3, Paulina M Young1, Cindy J Chambers3, Emanual Maverakis3, Cory A Dunnick4, April W Armstrong1. 1. 1 Department of Dermatology, Keck School of Medicine of the University of Southern California, Los Angeles, California. 2. 2 Department of Dermatology, Drexel University College of Medicine, Philadelphia, Pennsylvania. 3. 3 Department of Dermatology, University of California Davis School of Medicine, Sacramento, California. 4. 4 Department of Dermatology, University of Colorado School of Medicine, University of Colorado Denver, Aurora, Colorado.
Abstract
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.
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.
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