JMIR Publications

ABSTRACT

Background:

Teledermatological consultations offer the advantage of rapid diagnosis and care. Since 2019,. our institute at the University Medical Center Hamburg-Eppendorf is part of an interdisciplinary team for teledermatological support in German prisons as an alternative to extramural transports of patients.

Objective:

To analyze the benefits and limitations of teledermatology for patients with difficult access to medical specialties.

Methods:

We conducted a descriptive cross-sectional analysis of 651 requests for video consultations from the prisons from February 2020 to April 2023. All cases were performed in a store-and-forward mode (asynchronous operation) and additional option for live consultation for patient or inhouse staff (synchronous operation).

Results:

608 out of 651 requests (93.4 %) could be finalized and 43 (6.6 %) cases required additional work-up, including verifications of the dignity of tumours (22 of 43), which needed biopsies, further most frequent diagnoses were inflammatory and infectious skin conditions. Digital imaging of the skin lesions improved with the experience of the personnel but remained a challenge, with the photo quality also depending on the technical devices or available broadband supply.

Conclusions:

Teledermatological video consultation represents a very effective and resource-saving way of providing specialized care to patients in situations with difficult access to medical specialities. The video consultations with experts and exchange of knowledge about the cases presented, opened the opportunity to support intramural colleagues and enable them to take on similar cases on their own. One of the main challenges remains with the improvement of digital imaging and transmission.