Live interactive telemedicine consults with dermatologists appeared to result in improved treatment and positive outcomes, according to a report in the American Medical Association's Archives of Dermatology journal.

In a study funded by HHS' Agency for Healthcare Research and Quality, researchers examined the records of 1,490 patients who had a live teledermatology visit with a physician at the University of California at Davis between 2003 and 2005, and compared diagnoses and treatment plans between the referring physician and the dermatologist.

These visits resulted in changes in diagnosis for 69.9% of the patients and changes in disease management for 97.7%. Clinical improvement was seen in 68.7% of the 313 patients who were identified to have two or more virtual visits.

The most common changes from the referring physician's original diagnosis were changing the diagnosis from skin infection to “primary inflammatory process,” such as psoriasis or eczema appearing as a fungal infection; changing from malignant lesion to benign; and from changing a benign lesion diagnosis to malignancy.

In 67.5% of the patients, treatment was initiated or discontinued after a telemedicine consult.

“The downstream impact of (live interactive) teledermatology may include reduced costs associated with additional visits or medications as well as improved primary-care provider practice as a result of increased familiarity with dermatologic diagnoses and their associated management plans,” the researchers concluded.

The patients were referred from 31 primary-care facilities in California, and the authors noted that the teledermatology program cares for an underserved population “including a sizeable prison population,” and so the patients studied may not reflect the demographics of the overall U.S. population.