Kartik Dhaduk1, Daniel Miller1,2,3, Alan Schliftman3, Ammar Athar1, Zohair Ahmed Al Aseri4, Alison Echevarria3, Brian Hale3, Corey Scurlock1,3,5, Christian Becker1,2,3. 1. Department of Internal Medicine, Westchester Medical Center Health Network and New York Medical College, Valhalla, New York, USA. 2. Division of Pulmonary, Critical Care and Sleep Medicine, Westchester Medical Center Health Network and New York Medical College, Valhalla, New York, USA. 3. WMCHealth Network eHealth Center, Westchester Medical Center Health Network and New York Medical College, Valhalla, New York, USA. 4. Departments of Emergency Medicine and Critical Care, College of Medicine, King Saud University, Riyadh, Saudi Arabia. 5. Department of Anesthesiology, Westchester Medical Center Health Network and New York Medical College, Valhalla, New York, USA.
Abstract
Background/Introduction: In-house dermatology consultation services for hospitalized patients are not universally available in acute care hospitals. We encountered an unanticipated access gap for in-person dermatology consultations in our tertiary care hospital that routinely cares for complex high acuity patients with multiple comorbidities. To bridge this gap in specialist expertise in a timely manner, we expeditiously designed and implemented a telemedicine-supported inpatient dermatology consultation service. Methods: We conducted a retrospective review of 155 teledermatology consultations conducted between November 2017 and March 2019 as well as periodic prospective multidisciplinary process improvement meetings to optimize service-associated process maps and workflows. Results: Teledermatology consultations changed the working diagnosis of the primary team in 52.3% of cases and most commonly recommended medical management (61.9% of cases). In total 100% of patients accepted telemedicine support and rated their experience as positive. The first three periodic process improvement meetings led to significant improvements in teledermatology-related process maps and workflows. Discussion: Diagnostic concordance rates between the primary team and the teledermatologist were similar to those reported in the literature for in-person dermatology consultations. Important process improvements include establishing central responsibility of preparing and overseeing the consultation process, mandating the presence of a primary team representative during consultation and patient chart review by the teledermatologist before teleconsultation. Conclusion: Inpatient teledermatology consultation services can be instituted timely and continuously improved to reliably and effectively bridge access gaps, improve diagnostic accuracy and differentiate therapeutic approaches while maintaining patient satisfaction.
Background/Introduction: In-house dermatology consultation services for hospitalized patients are not universally available in acute care hospitals. We encountered an unanticipated access gap for in-person dermatology consultations in our tertiary care hospital that routinely cares for complex high acuity patients with multiple comorbidities. To bridge this gap in specialist expertise in a timely manner, we expeditiously designed and implemented a telemedicine-supported inpatient dermatology consultation service. Methods: We conducted a retrospective review of 155 teledermatology consultations conducted between November 2017 and March 2019 as well as periodic prospective multidisciplinary process improvement meetings to optimize service-associated process maps and workflows. Results: Teledermatology consultations changed the working diagnosis of the primary team in 52.3% of cases and most commonly recommended medical management (61.9% of cases). In total 100% of patients accepted telemedicine support and rated their experience as positive. The first three periodic process improvement meetings led to significant improvements in teledermatology-related process maps and workflows. Discussion: Diagnostic concordance rates between the primary team and the teledermatologist were similar to those reported in the literature for in-person dermatology consultations. Important process improvements include establishing central responsibility of preparing and overseeing the consultation process, mandating the presence of a primary team representative during consultation and patient chart review by the teledermatologist before teleconsultation. Conclusion: Inpatient teledermatology consultation services can be instituted timely and continuously improved to reliably and effectively bridge access gaps, improve diagnostic accuracy and differentiate therapeutic approaches while maintaining patient satisfaction.
Authors: Connor Drake; Tyler Lian; Blake Cameron; Kate Medynskaya; Hayden B Bosworth; Kevin Shah Journal: Telemed J E Health Date: 2021-03-25 Impact factor: 3.536
Authors: Cara N Cacioppo; Brian L Egleston; Dominique Fetzer; Colleen Burke Sands; Syeda A Raza; Neeraja Reddy Malleda; Elisabeth McCarty Wood; India Rittenburg; Julianne Childs; David Cho; Martha Hosford; Tina Khair; Jamil Khatri; Lydia Komarnicky; Trina Poretta; Fahd Rahman; Satish Shah; Linda J Patrick-Miller; Susan M Domchek; Angela R Bradbury Journal: Cancer Med Date: 2021-06-08 Impact factor: 4.452