Authors (including presenting author) :
Chung MH(1)(2), Sham TLJ(2), Cheng KC(1)(2), Wong SMC(1)(2)
Affiliation :
(1)Division of Dermatology, Department of Medicine, Queen Mary Hospital, (2)Department of Medicine, School of Clinical Medicine, The University of Hong Kong
Introduction :
Previous studies have demonstrated the reliability and accuracy of teledermatology in outpatient settings. It is cost-effective and can enhance accessibility to specialist care, leading to better patient outcomes. Fewer studies have investigated inpatient teledermatology, and there is a lack of local data. This study aims to determine whether store - and - forward teledermatology is accurate and reliable for inpatient dermatology consultations in the Hospital Authority setting.
Objectives :
(1) to determine if inpatient teledermatology is reliable and accurate
(2) to minimize hospital admissions and inpatient transferrals for Dermatology consultation.
(3) to enhance coverage of specialist care for the growing demands of inpatient Dermatology consultation
Methodology :
During the study period from April to June 2022, consecutive inpatient dermatology consultations were collected at a tertiary referral centre in Hong Kong. For each recruited patient, after assessment by an in-house dermatologist, another dermatologist who would practise store-and-forward teledermatology would then assess the same patient separately. The primary outcome measured was the concordance of their preferred diagnoses. Factors affecting the concordance would be evaluated.
Result & Outcome :
A total of 190 patients were recruited. The concordance between the teledermatologist and inpatient dermatologists was 80% for the preferred diagnosis, with a kappa coefficient of 0.75 (95% CI 0.71 – 0.78). The concordance of differential diagnoses was 97.4%, with a kappa coefficient of 0.76 (95% CI 0.73 - 0.8). The diagnostic accuracy rate was 68.8% (53 / 77) for the inpatient dermatologists and 59.7% (46 / 77) for the teledermatologist. Better quality of clinical photos (p-value < 0.001) was associated with agreement on the preferred diagnosis.
Inpatient teledermatology in a tertiary centre in Hong Kong was found to be reliable and accurate. Its utilization should be further encouraged to enhance specialist accessibility in hospitals without in-house dermatologist.
