Dermatological Diagnostic Acumen Improves with Use of a Simple Telemedicine System for Underserved Areas of South Africa
- 1 June 2011
- journal article
- research article
- Published by Mary Ann Liebert Inc in Telemedicine and e-Health
- Vol. 17 (5), 363-369
- https://doi.org/10.1089/tmj.2010.0163
Abstract
Objective: Telemedicine holds promise as a tool for improving the delivery of specialty care, especially in underserved regions, including those in South Africa. However, data that demonstrate the extent of its sustainable benefits to referring providers are currently insufficient. This study investigates whether utilization of a teledermatology network enhances the diagnostic acumen of primary care providers (PCPs) in underserved areas of South Africa. Materials and Methods: A longitudinal descriptive pilot study was conducted after establishing a telemedicine network linking University of Cape Town dermatology consultants to six providers from five underserved primary care sites using store-and-forward technology between October 2004 and January 2007. Of 120 total referrals, trend analysis was performed using 72 sets of patient histories, digital images, and corresponding consultant responses to evaluate the diagnostic concordance between six PCPs and teleconsultants over 12 consecutive referrals. Results: Strong positive Spearman rank-order correlations were observed between the number of referrals sent per PCP and proportion of primary diagnostic agreement with teledermatologists, rs=0.86 (p Conclusions: If a simple and inexpensive teledermatology solution is carefully implemented in a resource-limited setting, an improvement of PCP diagnostic acumen can be achieved with a relatively small number of referrals. This educational benefit to referring PCPs could be sustainable and would ultimately enhance the quality of dermatological care in these underserved regions.Keywords
This publication has 21 references indexed in Scilit:
- Operational teledermatology in Broken Hill, rural AustraliaAustralasian Journal of Dermatology, 2005
- Human resources for health: overcoming the crisisThe Lancet, 2004
- Teledermatology's Impact on Time to Intervention among Referrals to a Dermatology Consult ServiceTelemedicine and e-Health, 2002
- 6.3. Teledermatology in Sub-Saharan AfricaCurrent problems in dermatology, 2002
- Diagnostic Accuracy and Image Quality Using a Digital Camera for TeledermatologyTelemedicine Journal, 1999
- Comparison of Dermatologic Diagnoses by Primary Care Practitioners and Dermatologists: A Review of the LiteratureArchives of Family Medicine, 1999
- HIV-related skin diseasesThe Lancet, 1996
- Ability of primary care physicians to recognize physical findings associated with HIV infectionJAMA, 1995
- The validity and practicality of sun-reactive skin types I through VIArchives of Dermatology, 1988
- The Validity and Practicality of Sun-Reactive Skin Types I Through VIArchives of Dermatology, 1988