Dermatology is among the top specialties to use telemedicine. A June 2015 survey from telemedicine provider American Well found 76 percent of physicians find telemedicine the most valuable in dermatology consults. However, a recent study in JAMA Dermatology found significant gaps in care quality and accuracy in telemedicine consultations for dermatology.
Researchers posed as patients and sought direct-to-consumer telemedicine consultations via websites and smartphone apps offered to California residents that did not require live video interaction. Analyzing responses from 62 clinical encounters from 16 telemedicine websites, researchers indicate their findings "raise concerns about the quality of skin disease diagnosis and treatment provided by many DTC telemedicine websites."
According to the results, 32 percent of websites permitted patients to select their own clinician, while the rest automatically assigned a clinician for the consultation. Eight of the physicians were based internationally and did not have license to practice in California.
The researchers raised questions about the accuracy of diagnoses and offered treatments. They report no websites asked for photographic identification or verified the authenticity of submitted photographs (researchers used photographs from publicly available online image search engines).
"Major diagnoses were repeatedly missed, including secondary syphilis, eczema herpeticum, gram-negative folliculitis and polycystic ovarian syndrome. Regardless of the diagnoses given, treatments prescribed were sometimes at odds with existing guidelines," according to the researchers.
They concluded that while direct-to-consumer telemedicine websites can improve access to quality care, the programs must be properly implemented to do so.
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