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Accepted for/Published in: JMIR Dermatology

Date Submitted: Feb 23, 2022
Date Accepted: Jul 11, 2022

The final, peer-reviewed published version of this preprint can be found here:

Store-and-Forward Images in Teledermatology: Narrative Literature Review

Jiang SW, Flynn MS, Kwock JT, Nicholas MW

Store-and-Forward Images in Teledermatology: Narrative Literature Review

JMIR Dermatol 2022;5(3):e37517

DOI: 10.2196/37517

PMID: 35891983

PMCID: 9302578

Store-and-forward images in teledermatology: a narrative literature review

  • Simon W. Jiang; 
  • Michael Seth Flynn; 
  • Jeffery T. Kwock; 
  • Matilda W. Nicholas

ABSTRACT

Background:

Store-and-forward (SAF) teledermatology utilizes electronically stored information, including patient photographs and demographic information, for clinical decision-making asynchronous to the patient encounter. The integration of SAF teledermatology into clinical practice has been increasing in recent years, especially during the COVID-19 pandemic. Despite this growth, data regarding outcomes of SAF teledermatology are limited. A key distinction among current literature involves comparing the quality and utility of images obtained by patients and trained clinicians, as these metrics may vary by the clinical expertise of the photographer.

Objective:

This narrative literature review characterizes outcomes of SAF teledermatology through the lens of patient- versus clinician-initiated photography and highlights important future directions for and challenges of the field.

Methods:

A literature search of peer-reviewed research was performed between February and April of 2021. Key search terms included patient-initiated, patient-submitted, clinician-initiated, clinician-submitted, store-and-forward, asynchronous, remote, image, photograph, and teledermatology. Only studies published after 2001 in English were included. In total, 47 studies were identified from the PubMed electronic database and Google Scholar after omitting duplicate articles.

Results:

Image quality and diagnostic concordance are generally lower and more variable with patient-submitted images, which may impact their decision-making utility. SAF teledermatology can improve efficiency of and access to care when photographs are taken by either clinicians or patients. Clinical outcomes of clinician-submitted images are comparable to those of in-person visits in the few studies that have investigated these outcomes. Coinciding with the onset of the COVID-19 pandemic, asynchronous teledermatology helped minimize unnecessary in-person visits in the outpatient setting, as many uncomplicated conditions could be adequately managed remotely via images captured by patients and referring clinicians. For the inpatient setting, SAF teledermatology minimized unnecessary contact during dermatology consultations, although current studies are limited by the heterogeneity of their outcomes.

Conclusions:

In general, photographs taken by trained clinicians are higher quality and have better and more relevant diagnostic and clinical outcomes. SAF teledermatology helped clinicians avoid unnecessary physical contact with patients in the outpatient and inpatient settings during the COVID-19 pandemic. Asynchronous teledermatology will likely play a greater role in the future, aided by artificial intelligence decision-making and integration into medical education. However, obstacles as summarized in this review should be addressed before its widespread implementation into clinical practice.


 Citation

Please cite as:

Jiang SW, Flynn MS, Kwock JT, Nicholas MW

Store-and-Forward Images in Teledermatology: Narrative Literature Review

JMIR Dermatol 2022;5(3):e37517

DOI: 10.2196/37517

PMID: 35891983

PMCID: 9302578

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