Accepted for/Published in: JMIR Dermatology
Date Submitted: Oct 19, 2024
Date Accepted: Apr 19, 2025
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
Provider Perspectives on Pediatric Store and Forward Teledermatology at Boston Medical Center: Cross-sectional Survey
ABSTRACT
Background:
Access to pediatric dermatologists is limited by prolonged waiting times, limited appointments, and uneven geographic availability. Provider-to-provider store-and-forward teledermatology (SAFTD), which allows referring providers to send images and clinical information to dermatology for asynchronous evaluation, triage, and recommendations, alleviates these barriers. Therefore, we hypothesized that SAFTD could be particularly helpful to diverse, low-income patients seen at community health centers affiliated with a safety-net hospital (SNH) system like Boston Medical Center (BMC); these patients face increased healthcare challenges related to language barriers and limited resources for accessing care.
Objective:
Examine provider perspectives on pediatric SAFTD in a safety-net hospital setting.
Methods:
We conducted an anonymous cross-sectional survey of BMC pediatric dermatologists, dermatology residents, pediatricians, pediatric residents, and pediatric nurse practitioners who use the SAFTD service. This study was approved as exempt per BMC institutional review board (H-43783). Surveys included both qualitative and Likert scale data which were examined via thematic and univariate analyses, respectively.
Results:
Among dermatology providers fielding SAFTD cases (n=7), mean satisfaction was 4 out of a maximum score of 5, with 85.7% preferring it to traditional referrals given improved triage and faster intervention, although patient comprehension of recommendations and photo quality (particularly focus, lighting, and adequate number of images) could be improved. Pediatric providers (n=15) reported a mean satisfaction score 4.93 of 5, 100% preferring it over traditional referral methods (primarily citing faster intervention and increased patient convenience), with 93% reporting they learned new management strategies, although some cited difficulty capturing and uploading high-quality photos and having limited time to act upon recommendations.
Conclusions:
Pediatric SAFTD is an efficient and educational means of delivering care to our safety-net pediatric patient population. We can recommend SAFTD to SNH’s, particularly if photography support and protected time can be provided to participating providers. Clinical Trial: n/a
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