Teledermatology in practice: Report of Mayo Clinic experience

Nessa Aghazadeh Mohandesi; Tudor Puiu; Setu Mittal; Matthew R Hall; Olayemi Sokumbi; Aaron R Mangold; Michael B Colgan; Megha M Tollefson; Julio C Sartori-Valinotti

doi:10.1177/20552076241234581

Teledermatology in practice: Report of Mayo Clinic experience

Digit Health. 2024 Feb 25:10:20552076241234581. doi: 10.1177/20552076241234581. eCollection 2024 Jan-Dec.

Authors

Nessa Aghazadeh Mohandesi¹, Tudor Puiu², Setu Mittal¹, Matthew R Hall², Olayemi Sokumbi², Aaron R Mangold³, Michael B Colgan^{1

4}, Megha M Tollefson¹, Julio C Sartori-Valinotti¹

Affiliations

¹ Department of Dermatology, Mayo Clinic, Rochester, MN, USA.
² Department of Dermatology, Mayo Clinic, Jacksonville, FL, USA.
³ Department of Dermatology, Mayo Clinic, Scottsdale, AZ, USA.
⁴ Department of Dermatology, Mayo Clinic Health System, Eau Claire, WI, USA.

Abstract

Background: Delivery of dermatologic care through telemedicine was accelerated by the COVID-19 pandemic. We sought to analyze the teledermatology experience across Mayo Clinic's health care system to identify strengths and limitations of teledermatology.

Methods: Electronic health records of dermatology televisits were reviewed from multiple U.S. Mayo Clinic sites from January 2020 through January 2021.

Results: A total of 13,181 dermatology televisits were conducted in 6468 unique patients. Patients were primarily female (60.2%), and mean age of all patients was 34.1 years. Synchronous / live video conferencing visits were the most common (40.0%) telecare modality. Synchronous / live audio conferencing and asynchronous / store-and-forward visits comprised 33.0% and 27.0% of appointments. In total, 3944 televisits (29.9%) were successfully concluded via a single appointment. An in-person appointment was needed for 1693 patients (26.2%) after their initial televisit. For patients with a single televisit, synchronous / live video conferencing was the most common virtual modality (58.0% vs 32.2% of patients with multiple visits, p < 0.001). Patients needing in-person follow-up visits were slightly older than those who did not (mean [SD], 38.8 [22.3] vs 35.0 [23.6] years; p < 0.001) but without any sex-based difference. Around one-third of patients needed an in-person follow-up visit after their initial asynchronous / store-and-forward visit which was higher when compared with synchronous / live audio and video conferencing.

Conclusion: Single dermatology televisits effectively managed nearly one-third of patients who did not require in-person follow-up. An initial synchronous / live video conferencing was more likely to yield a single clinical encounter, whereas asynchronous / store-and-forward visits required more in-person follow-up. Future studies are required that focus on dermatology-specific cost, diagnoses, access, quality of care, and outcomes.

Keywords: Dermatology; telehealth; telemedicine.