Currently submitted to: JMIR Dermatology
Date Submitted: Dec 5, 2025
Open Peer Review Period: Dec 24, 2025 - Feb 18, 2026
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Demographic and Geographic Trends in Teledermoscopy Utilization and Implications for Access to Care
ABSTRACT
Background:
Disparities in access to dermatologic care in medically underserved and rural communities within Northeast Ohio are reflective of national trends. MetroHealth’s teledermoscopy tool, Snapshot, is intended to streamline triage for potentially cancerous skin lesions. However, its utilization patterns and ability to expand access to care have not been studied.
Objective:
This study aimed to identify demographic and geographic trends in Snapshot utilization and assess its capacity to reach populations that may lack access to dermatologic care.
Methods:
County-level data on dermatologist density was extracted from records obtained from the American Academy of Dermatology (AAD). Spearman correlations were used to examine the relationship between Snapshot utilization and dermatologist density at the county level. A retrospective analysis of all Snapshot encounters from 2018 to 2025 was performed to identify demographic characteristics and clinical outcomes of this patient population. A ZIP code-level analysis was performed to identify areas with the greatest Snapshot encounters.
Results:
A total of 1,274 patients used Snapshot between 2018 and 2025, with 2,016 total Snapshot encounters. At the county level, dermatologist density was strongly positively correlated with Snapshot utilization (Pearson r=0.968, P<0.001; Spearman ρ=0.709, P=.028). A ZIP code level analysis demonstrated that the highest rates of utilization clustered around ZIP codes containing MetroHealth clinics offering Snapshot due to its walk-in design. However, 58% of Snapshot users were new patients with no prior dermatology encounters, indicating its potential role as an entry point into specialty care.
Conclusions:
Snapshot utilization appears to be strongly driven by dermatologist density geographic proximity to a MetroHealth clinic, suggesting that it is not bridging geographical gaps in access to dermatological care but is likely acting as a triage tool for patients with potentially cancerous skin lesions. However, the high proportion of new users suggests that it is acting as an entry point for patients who were not previously connected to dermatological care. Further work comparing Snapshot users with the broader MetroHealth dermatology population is needed to elucidate the characteristics of those who are currently benefiting from Snapshot and identify the ways it can be implemented to reach those who remain disconnected from care.
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