Impact of teledermatology on the accessibility and efficiency of dermatology care in an urban safety-net hospital: A pre-post analysis

Background: Teledermatology enables dermatologists to remotely triage and evaluate dermatology patients, but previous studies have questioned whether teledermatology is clinically efficient.

Objective: To determine whether implementation of a teledermatology system at the Zuckerberg San Francisco General Hospital and Trauma Center has improved the accessibility and efficiency of dermatology care delivery.

Methods: Retrospective, pre-post analysis of a pre-teledermatology cohort (June 2014-December 2014) compared with a post-teledermatology cohort (June 2017-December 2017).

Results: Our analysis captured 11,586 patients. After implementation of teledermatology, waiting times for new patients decreased significantly (84.6 days vs 6.7 days; P < .001), total cases evaluated per month increased significantly (754 vs 901; P = .008), and number of cases evaluated per dermatologist-hour increased significantly (2.27 vs 2.63; P = .010). In the post-teledermatology period, 61.8% of teledermatology consults were managed without a clinic visit.

Limitations: We were unable to control for changes in demand for dermatology evaluations between the 2 periods and did not have a control group with which to compare our results.

Conclusion: The dermatology service was more accessible and more efficient after implementation of teledermatology, suggesting that capitated health care settings can benefit from implementation of a teledermatology system.