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Commentary
Teledermatology Implementation: The Importance of a Clear Objective
Teledermatología: la importancia de implantarla con un objetivo claro
I. García-Dovala,b
a Servicio de Dermatología, Complexo Hospitalario Universitario de Vigo, Vigo, Spain
b Unidad de Investigación, Fundación Academia Española de Dermatología y Venereología, Madrid, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Studies of teledermatology &#40;TD&#41; indicate that this technique appears to be most effective at ruling out skin tumors&#44; improving the prioritization of consultations&#44; and reducing waiting times&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The article by Romero et al&#46;<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> in this issue of <span class="elsevierStyleSmallCaps">Actas Dermo-Sifiliogr&#225;ficas</span> describes the practice of TD in Spain between 2009 and 2014&#46; The results&#44; probably limited to the public health system&#44; reveal that the implementation of TD has increased&#46; In 2014&#44; 26&#37; of centers used TD&#46; How does this figure square with the fact that TD consultations account for just 1&#37; of dermatology consultations in Spain&#63;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">5</span></a> The most plausible interpretation is that the variability among centers is high&#8212;making measurement more challenging&#8212;and that most centers see only a small number of patients by TD&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Many of the characteristics described in the article suggest that TD has been implemented anarchically in Spain&#46; The variability of the objectives and the resources used is surprising&#46; In many cases&#44; TD is not integrated with electronic health records or the clinic does not assign time for TD&#46; The data also indicate that the efficiency of TD diagnosis increases with the distance between the dermatologist and the patient&#46; Paradoxically&#44; TD was used more frequently in urban areas&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">In this context&#44; the position of the Spanish Academy of Dermatology and Venereology &#40;AEDV&#41; is especially important&#46; The AEDV recommends that TD be implemented in accordance with certain rules&#44; as part of a larger service portfolio&#44; with a procedure for assessing results&#44; and most importantly&#44; with the aim of addressing specific problems&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">6</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">The decision to apply a particular model of TD should take the objective into account&#46; In Spain&#39;s context of local health care provision&#44; waiting lists&#44; and overcrowded clinics&#44; TD would seem to be most useful for prioritization&#46; If prioritization is the objective&#44; perhaps the best method would be to use TD to filter all consultations&#44; as our center has been doing for years&#46; The result appears to be positive&#44; but doubts remain regarding the effectiveness of the system and the acceptance of TD by primary care physicians and patients&#46; Other objectives would require a different sort of organization and generate different uncertainties&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">TD is not &#8220;one-size-fits-all&#8221;&#59; this technique can be used in many organizational models&#46; The first step towards implementing the most appropriate system is to clarify the objective&#46;</p></span>"
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Article information
ISSN: 15782190
Original language: English
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Idiomas
Actas Dermo-Sifiliográficas
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