Published December 2007
Teledermatology is one of the most active applications of telemedicine rendered in the United States. Dermatology is particularly suited to the use of advanced communication technologies and the Internet for delivery of care. By using advanced communication technologies, dermatologists may be able to widen their reach to patients in a cost-effective manner, ameliorating the maldistribution of specialty care. The following Guidelines were designed to aid in the development and practice of coherent, effective, safe and sustainable teledermatology practices. Establishing Guidelines for teledermatology may improve clinical outcomes and promote informed and reasonable patient expectations.
The Practice Guideline for Teledermatology covers two major areas, reflecting the basic component processes associated with most teledermatology consultations: technical and clinical Administrative aspects of clinical teleconsultations in general are covered in the American Telemedicine Association’s TeleHealth Administrative document. In teledermatology, store-and-forward (S&F) communication typically refers to the sending or forwarding of digital images and associated patient data to the specialist for storage and consultation. For real-time video teleconferencing (VTC), providers and patients interact via live videoconferencing. The recommendations apply to S&F, VTC and hybrid (utilizing both S&F and VTC) modes for teledermatology.
The document contains Guidelines for the practice of teledermatology that are required whenever feasible and practical as determined by the referring clinician practicing under local conditions. These Guidelines are presented first in the document and are identifiable in the text when “shall” is used (indicated by bold italics). In the following section, the document also contains Recommendations for Best Practices that are indicated in the text by “should” to indicate an optimal recommended action, one that is particularly suitable, without mentioning or excluding others. The third section contains optional or permissible action indicated by “may/attempt to” to indicate additional points that may be considered to further optimize the teledermatology consult process.
A glossary of important terms, references to literature, and informative web sites are included at the end of the document for further consideration. An Appendix is included with information about the Digital Imaging & Communications in Medicine (DICOM) standard that is likely to impact the practice of teledermatology in the very near future.