Dermatology could serve as model for e-visits
A recent study finds that remote online visits with dermatologists achieved equivalent clinical outcomes for acne patients. Also, doctors and patients ranked the e-visits as convenient and time-saving and said they could be used as a model for chronic conditions such as diabetes and hypertension.
The study, conducted by the Center for Connected Health, a division of Partners HealthCare, was published in the April issue of Archives of Dermatology.
Following an initial face-to-face consultation, study participants carried out four follow-up visits using either the e-visits technology or conventional office care.
E-visits patients were given a digital camera and trained to take and transmit images to their doctor. Every six weeks, patients in the e-visits group were prompted to send images of their skin and an update, via a secure Web site, to their dermatologist, who then responded with advice and electronic prescriptions. The degree of clinical improvement between both groups was compared.
The study included 121 patients with mild to moderate facial acne. It was conducted at Massachusetts General and Brigham and Women's Hospitals in Boston.
Quality of care was equivalent in the two groups as measured by a decrease in acne lesions over time. Most patients in the e-visits group agreed that their dermatologist could assess their acne just as well using an e-visit as in person (76 percent) and that they could express their concerns and questions about acne as well by e-visit as by office visit (83 percent). Ninety-one percent of participants would consider using e-visits again.
"This study is among the first to examine the clinical effectiveness of online visits between specialists and patients without them needing to communicate simultaneously," said Alice Watson, MD, corporate manager, Center for Connected Health, and the study's lead author. "This data shows that digital images and patient survey responses provide sufficient information for dermatologists to make appropriate treatment decisions. E-visits achieved comparable clinical results, were time-saving for patients and well-received by patients and physicians."
"The e-visits platform has proven to be a true visit replacement rather than just an addition to conventional care," said Joseph C. Kvedar, MD, director, Center for Connected Health and a dermatologist. "This data demonstrates that this technology can successfully be used to deliver follow-up care over a period of several months. We believe that this model of care could be expanded to other non-urgent and chronic conditions, such as diabetes or hypertension. The center is currently conducting additional research to determine if equivalent quality of care can be maintained across other clinical conditions."
RelayHealth provided the e-visits platform used in this study.