Introduction: In 2019, Maccabi Health Services (MHS) rolled out the store-and-forward “Dermadetect” teledermatology consultation (TC) application. Study goal was to analyze MHS records of TCs (August 2019–February 2021) for the rate and reasons for face-to-face consultations (FTFC) occurring shortly after a TC with emphasis on FTFCs resulting in a different diagnosis for the same indication. Methods: The records of FTFCs held up shortly after TCs were reviewed and classified into cases marked as unsuited for teledermatology, cases in which the indication differed, and cases with the same indication, which were analyzed for concordance of diagnoses. Results: Dermadetect was used by 12,815 MHS beneficiaries. In 30% of cases, following FTFC occurred within the subsequent 5 months, and 901 of them occurred in the subsequent 2 weeks and were analyzed. Thirty percent were not suited for teledermatology, 15% were held for a different indication, and 55% occurred for the same indication. The diagnosis concordance between the TC and recurrent FTFC for the same indication was 97.4%, with full concordance at 68.1% and partial concordance at 29.3%. Overall, 13 patients (1.4%) of the 901 patients using the application only once had a subsequent FTFC within 2 weeks and received a different diagnosis than the one given in the TC. Conclusions: When considering the implementation of store-and-forward TC’s, a 30% rate of following FTFC’s during the next 5 months should be considered when planning the reimbursement model. Diagnosis discordance may be disregarded due to its low rates.

1.
Gonzalez Coloma
F
,
Sandoval Garces
M
,
Gedda Quiroga
V
,
Bley Banda
C
.
Teledermatology in remote parts of Chile: experience in 4 isolated rural areas
.
Actas Dermosifiliogr
.
2019
;
110
(
8
):
653
8
.
2.
Byrom
L
,
Lucas
L
,
Sheedy
V
,
Madison
K
,
McIver
L
,
Castrisos
G
, et al
.
Tele-Derm National: a decade of teledermatology in rural and remote Australia
.
Aust J Rural Health
.
2016
;
24
(
3
):
193
9
.
3.
Peracca
SB
,
Jackson
GL
,
Lamkin
RP
,
Mohr
DC
,
Zhao
M
,
Lachica
O
, et al
.
Implementing teledermatology for rural veterans: an evaluation using the RE-AIM framework
.
Telemed J E Health
.
2021
;
27
(
2
):
218
26
.
4.
Messagier
AL
,
Blaizot
R
,
Couppié
P
,
Delaigue
S
.
Teledermatology use in remote areas of French guiana: experience from a long-running system
.
Front Public Health
.
2019
;
7
:
387
.
5.
Altunisik
N
,
Turkmen
D
,
Calikoglu
E
,
Sener
S
.
Views and experiences of dermatologists in Turkey about teledermatology during the COVID-19 pandemic
.
J Cosmet Dermatol
.
2020
;
19
(
10
):
2460
3
.
6.
Jariwala
NN
,
Snider
CK
,
Mehta
SJ
,
Armstrong
JK
,
Smith-McLallen
A
,
Takeshita
J
, et al
.
Prospective implementation of a consultative store-and-forward teledermatology model at a single urban academic health system with real cost data subanalysis
.
Telemed J E Health
.
2021
;
27
(
9
):
989
96
.
7.
Pasadyn
SR
,
McAfee
JL
,
Vij
A
,
Warren
CB
.
Store-and-forward teledermatology impact on diagnosis, treatment and dermatology referrals: comparison between practice settings
.
J Telemed Telecare
.
2022
;
28
(
3
):
177
81
.
8.
Rizvi
SMH
,
Schopf
T
,
Sangha
A
,
Ulvin
K
,
Gjersvik
P
.
Teledermatology in Norway using a mobile phone app
.
PLoS One
.
2020
;
15
(
4
):
e0232131
.
9.
G Bianchi
M
,
Santos
A
,
Cordioli
E
.
Benefits of teledermatology for geriatric patients: population-based cross-sectional study
.
J Med Internet Res
.
2020
;
22
(
4
):
e16700
.
10.
Yang
X
,
Barbieri
JS
,
Kovarik
CL
.
Cost analysis of a store-and-forward teledermatology consult system in Philadelphia
.
J Am Acad Dermatol
.
2019
;
81
(
3
):
758
64
.
11.
Villa
L
,
Matz
O
,
Olaciregui Dague
K
,
Kluwig
D
,
Rossaint
R
,
Brokmann
JC
.
The assessment of dermatological emergencies in the emergency department via telemedicine is safe: a prospective pilot study
.
Intern Emerg Med
.
2020
;
15
(
7
):
1275
9
.
12.
Datta
SK
,
Warshaw
EM
,
Edison
KE
,
Kapur
K
,
Thottapurathu
L
,
Moritz
TE
, et al
.
Cost and utility analysis of a store-and-forward teledermatology referral system: a randomized clinical trial
.
JAMA Dermatol
.
2015
;
151
(
12
):
1323
9
.
13.
Lopez-Villegas
A
,
Bautista-Mesa
RJ
,
Baena-Lopez
MA
,
Alvarez-Moreno
ML
,
Montoro-Robles
JE
,
Vega-Ramirez
FA
, et al
.
Economic impact and cost savings of teledermatology units compared to conventional monitoring at hospitals in southern Spain
.
J Telemed Telecare
.
2022
;
28
(
6
):
436
44
.
14.
Seiger
K
,
Hawryluk
EB
,
Kroshinsky
D
,
Kvedar
JC
,
Das
S
.
Pediatric dermatology eConsults: reduced wait times and dermatology office visits
.
Pediatr Dermatol
.
2020
;
37
(
5
):
804
10
.
15.
Vidal-Alaball
J
,
Garcia Domingo
JL
,
Garcia Cuyas
F
,
Mendioroz Pena
J
,
Flores Mateo
G
,
Deniel Rosanas
J
, et al
.
A cost savings analysis of asynchronous teledermatology compared to face-to-face dermatology in Catalonia
.
BMC Health Serv Res
.
2018
;
18
(
1
):
650
.
16.
Baranowski
MLH
,
Balakrishnan
V
,
Chen
SC
.
Patient satisfaction with the veteran’s administration teledermatology service
.
J Am Acad Dermatol
.
2023
;
88
(
5
):
e237
42
.
17.
Dhaduk
K
,
Miller
D
,
Schliftman
A
,
Athar
A
,
Al Aseri
ZA
,
Echevarria
A
, et al
.
Implementing and optimizing inpatient access to dermatology consultations via telemedicine: an experiential study
.
Telemed J E Health
.
2021
;
27
(
1
):
68
73
.
18.
Wang
RF
,
Trinidad
J
,
Lawrence
J
,
Pootrakul
L
,
Forrest
LA
,
Goist
K
, et al
.
Improved patient access and outcomes with the integration of an eConsult program (teledermatology) within a large academic medical center
.
J Am Acad Dermatol
.
2020
;
83
(
6
):
1633
8
.
19.
Dovigi
E
,
Kwok
EYL
,
English
JC
3rd
.
A framework-driven systematic review of the barriers and facilitators to teledermatology implementation
.
Curr Dermatol Rep
.
2020
;
9
(
4
):
353
61
.
20.
Faye
O
,
Bagayoko
CO
,
Dicko
A
,
Cisse
L
,
Berthe
S
,
Traore
B
, et al
.
A teledermatology pilot programme for the management of skin diseases in primary health care centres: experiences from a resource-limited country (Mali, west africa)
.
Trop Med Infect Dis
.
2018
;
3
(
3
):
88
.
21.
Dobry
A
,
Begaj
T
,
Mengistu
K
,
Sinha
S
,
Droms
R
,
Dunlap
R
, et al
.
Implementation and impact of a store-and-forward teledermatology platform in an urban academic safety-net health care system
.
Telemed J E Health
.
2021
;
27
(
3
):
308
15
.
22.
Giavina-Bianchi
M
,
Sousa
R
,
Cordioli
E
.
Part I: accuracy of teledermatology in inflammatory dermatoses
.
Front Med
.
2020
;
7
:
585792
.
23.
Miller
BJ
,
Finnane
A
,
Vun
Y
,
Halloran
S
,
Stapelberg
A
,
Soyer
HP
, et al
.
Real-time teledermatology clinics in a tertiary public hospital: a clinical audit
.
Australas J Dermatol
.
2020
;
61
(
4
):
e383
7
.
24.
Gabel
CK
,
Nguyen
E
,
Karmouta
R
,
Liu
KJ
,
Zhou
G
,
Alloo
A
, et al
.
Use of teledermatology by dermatology hospitalists is effective in the diagnosis and management of inpatient disease
.
J Am Acad Dermatol
.
2021
;
84
(
6
):
1547
53
.
25.
Marchetti
A
,
Dalle
S
,
Maucort-Boulch
D
,
Amini-Adl
M
,
Debarbieux
S
,
Poulalhon
N
, et al
.
Diagnostic concordance in tertiary (Dermatologists-to-Experts) teledermoscopy: a final diagnosis-based study on 290 cases
.
Dermatol Pract Concept
.
2020
;
10
(
3
):
e2020071
.
26.
López Seguí
F
,
Franch Parella
J
,
Gironès García
X
,
Mendioroz Peña
J
,
García Cuyàs
F
,
Adroher Mas
C
, et al
.
A cost-minimization analysis of a medical record-based, store and forward and provider-to-provider telemedicine compared to usual care in catalonia: more agile and efficient, especially for users
.
Int J Environ Res Public Health
.
2020
;
17
(
6
):
2008
.
27.
Bertrand
SE
,
Weinstock
MA
,
Landow
SM
.
Teledermatology outcomes in the providence veterans health administration
.
Telemed J E Health
.
2019
;
25
(
12
):
1183
8
.
28.
McAfee
JL
,
Vij
A
,
Warren
CB
.
Store-and-forward teledermatology improves care and reduces dermatology referrals from walk-in clinics: a retrospective descriptive study
.
J Am Acad Dermatol
.
2020
;
82
(
2
):
499
501
.
29.
Mehrtens
SH
,
Shall
L
,
Halpern
SM
.
A 14-year review of a UK teledermatology service: experience of over 40 000 teleconsultations
.
Clin Exp Dermatol
.
2019
;
44
(
8
):
874
81
.
30.
Zakaria
A
,
Maurer
T
,
Su
G
,
Amerson
E
.
Impact of teledermatology on the accessibility and efficiency of dermatology care in an urban safety-net hospital: a pre-post analysis
.
J Am Acad Dermatol
.
2019
;
81
(
6
):
1446
52
.
31.
Giavina Bianchi
M
,
Santos
AP
,
Cordioli
E
.
The majority of skin lesions in pediatric primary care attention could be managed by Teledermatology
.
PLoS One
.
2019
;
14
(
12
):
e0225479
.
32.
Borve
A
,
Dahlen Gyllencreutz
J
,
Terstappen
K
,
Johansson Backman
E
,
Aldenbratt
A
,
Danielsson
M
, et al
.
Smartphone teledermoscopy referrals: a novel process for improved triage of skin cancer patients
.
Acta Derm Venereol
.
2015
;
95
(
2
):
186
90
.
33.
Finnane
A
,
Dallest
K
,
Janda
M
,
Soyer
HP
.
Teledermatology for the diagnosis and management of skin cancer: a systematic review
.
JAMA Dermatol
.
2017
;
153
(
3
):
319
27
.
34.
Keller
JJ
,
Johnson
JP
,
Latour
E
.
Inpatient teledermatology: diagnostic and therapeutic concordance among a hospitalist, dermatologist, and teledermatologist using store-and-forward teledermatology
.
J Am Acad Dermatol
.
2020
;
82
(
5
):
1262
7
.
35.
Xiong
M
,
Pfau
J
,
Young
AT
,
Wei
ML
.
Artificial intelligence in teledermatology
.
Curr Derm Rep
.
2019
;
8
(
3
):
85
90
.
36.
Kazi
R
,
Evankovich
MR
,
Liu
R
,
Liu
A
,
Moorhead
A
,
Ferris
LK
, et al
.
Utilization of asynchronous and synchronous teledermatology in a large health care system during the COVID-19 pandemic
.
Telemed J E Health
.
2021
;
27
(
7
):
771
7
.
37.
Zakaria
A
,
Miclau
TA
,
Maurer
T
,
Leslie
KS
,
Amerson
E
.
Cost minimization analysis of a teledermatology triage system in a managed care setting
.
JAMA Dermatol
.
2021
;
157
(
1
):
52
8
.
You do not currently have access to this content.