What is Teledermatology?

Learn more about what teledermatology is, the different types of technologies, the benefits of each technology and its application in real life.

Author: Jennifer Highland, Content Manager of Miiskin | Reviewed by: Jon Friis, founder, and CEO of Miiskin
Last content update: June, 2023.

Table of Content
What is teledermatology? | Live Video Conferencing | Store-and-forward teledermatology | Hybrid teledermatology | Teledermatology applications  | Takeaway | Teledermatology White Paper

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The scarcity of dermatologists and the growing patient population in Western countries have resulted in a shortage of skilled clinicians available to deliver specialized dermatological care.

Consequently, patients are experiencing prolonged waiting periods for examinations, which can pose potential risks to their health¹.

In the ever-evolving landscape of healthcare, advancements in technology have paved the way for innovative approaches to patient care. Teledermatology, a branch of telemedicine, is a promising solution that bridges the gap between dermatologists and patients, revolutionizing the way skin healthcare is diagnosed and treated.

This article provides you with a comprehensive understanding of teledermatology, shedding light on its definition, its different technologies, and the full stack of benefits it offers.

Whether you’re a healthcare provider, a dermatology researcher, or work for a pharma company about to launch a new drug to the market, this article will help you understand the potential of telemedicine in dermatology and its many applications in skin healthcare.

Besides, implementing teledermatology software is a great way to attract new patients to your dermatology clinic and boost your business, but it is even more important when you are setting up a new dermatology practice.

What is Teledermatology?

Teledermatology (also referred to as telederm) refers to the practice of using telecommunications technology to provide dermatological care remotely². It enables dermatologists and other healthcare providers to evaluate, diagnose, and treat skin conditions without the need for in-person visits.

Instead, the consultation takes place through a secure, HIPAA-compliant telemedicine platform in which patients can share information regarding their chief complaint, and symptoms together with some digital images and live or stored-videos allowing patients to receive skin healthcare care from the comfort of their own homes.

Teledermatology is one of the most common telemedicine applications. Since most skin diseases are visible, dermatologists can expand their reach to patients cost-effectively by using advanced telehealth technologies³. 

Types of teledermatology

Teledermatology is usually delivered via store-and-forward communications, live video conferencing⁴ or a hybrid model (a mix between both).

• Synchronous (live video conferencing)  
• Asynchronous (store-and-forward)
• Hybrid teledermatology combines elements of real-time and store-and-forward teledermatology

1. Synchronous teledermatology

Synchronous teledermatology (also known as live video conferencing) enables the interaction between patients and providers in real-time using telecommunications technology, simulating an in-person visit.

Benefits of synchronous teledermatology

Convenience: Synchronous teledermatology eliminates the need for patients to travel to healthcare facilities for in-person visits, which is convenient for patients. Patients can attend appointments from their homes, which is particularly beneficial for individuals with mobility issues, transportation challenges, or busy schedules.

Increased access for people in rural areas: Synchronous teledermatology breaks down geographical barriers, providing individuals in rural areas with improved access to healthcare. Patients who may otherwise face challenges in traveling long distances can now connect with healthcare providers remotely. 

Real-time interaction: Patients can engage in direct, face-to-face communication with their healthcare provider, simulating an in-person visit. This real-time interaction enables patients to discuss their chief complaint, describe symptoms, and ask questions, fostering a more comprehensive understanding of their condition and facilitating personalized care.

Lengthier interaction with healthcare providers: Synchronous teledermatology allows patients to have more in-depth interactions with their healthcare providers compared to store-and-forward telemedicine. Patients can take the time to provide detailed information about their skin issue and ask follow-up questions. 

Disadvantages of synchronous teledermatology 

In spite of all the advantages it brings, in many cases, synchronous telehealth is inefficient in dermatology. Although it tries to mimic a physical consultation there are a few challenges when using this technology.

Inefficient use of the provider’s time: Synchronous teledermatology can sometimes be less time-efficient compared to in-person visits. Technical issues, connectivity problems, or delays in video/audio transmission can disrupt the flow of the consultation and consume valuable time. 

No time savings over in-person consultations: For providers, synchronous teledermatology may not offer significant time savings compared to in-person consultations. While it eliminates the need for travel, the overall duration of the consultation can be similar, especially when both parties need to navigate technical aspects or when detailed discussions are required. 

Dependency on high-speed internet and video quality: Synchronous telehealth relies heavily on a stable, high-speed internet connection and high-quality video/audio capabilities. Any disruptions in internet connectivity or poor video quality can hinder the consultation experience and affect the accuracy of visual assessments. 

Short patient delays creating a backlog: Similar to in-person visits, even short patient delays in live video conferencing can create a backlog, especially when providers schedule consecutive appointments. Delays from one patient can have a cascading effect, impacting subsequent appointments and potentially causing frustration for both patients and providers. 

Potential embarrassment for patients: Live telemedicine consultations may pose challenges for patients who have skin lesions located in more private or sensitive body areas. Patients may feel self-conscious or embarrassed about exposing these areas on camera. This can create barriers to communication or lead to patients being less forthcoming about their condition, potentially impacting the accuracy of the assessment.

2. Asynchronous teledermatology

Asynchronous teledermatology (also known as store and forward telehealth in dermatology) enables the transmission of patient information to dermatologists for review at a later time.

Unlike synchronous telehealth, which involves real-time interactions, asynchronous teledermatology allows for a delayed communication between patients and dermatologists.

With this type of technology, patients capture high-quality images and/or videos of their skin condition or lesion using a digital camera or smartphone. They then securely transmit these images, along with relevant medical history and symptoms, to dermatology providers.

Multiple studies have indicated that in some cases, store and forward teledermatology exhibits a higher level of accuracy that even surpasses in-person encounters. This may be attributed to the enhanced resolution provided by mobile phone cameras^5.

Benefits of asynchronous teledermatology

In addition to the benefits mentioned above for Live Video Conferencing (such as convenience and increased access) store-and-forward teledermatology brings an added set of benefits to the table.

Reduced waiting times: With asynchronous teledermatology, the waiting time to obtain a consultation is significantly reduced. Instead of waiting weeks or months for an in-person or live video appointment, patients can submit their case electronically and receive a dermatologist’s evaluation within a shorter timeframe. This expedited process ensures that patients can begin necessary treatments or interventions sooner.

Hastens treatment for urgent patients: Asynchronous teledermatology is particularly beneficial for urgent cases that require prompt attention. Dermatologists can prioritize and review urgent cases quickly, accelerating the treatment process and potentially preventing complications or disease progression. This timely intervention can be critical in dermatological emergencies such as the excision of a suspicious mole that appears to have changed over time.

Increased number of managed patient cases: Store and forward teledermatology enables dermatologists to efficiently manage a higher number of patient cases. By eliminating the constraints of physical appointments and travel time, dermatologists can review and evaluate a larger volume of cases. This scalability allows for increased efficiency and access to specialized care for a greater number of patients.

Improved patient satisfaction: Asynchronous teledermatology has shown to enhance patient satisfaction. It provides patients with convenient access to expert dermatological opinions and reduces the frustration associated with long waiting times for in-person appointments. Patients can receive timely evaluations and treatment recommendations, leading to higher satisfaction with the healthcare experience.

Less embarrassing for patients: Store and forward telemedicine may be less embarrassing for patients as they can take as many photos as they want to conceal private areas. Patients may feel less self-conscious about submitting a close-up photo than doing a live video exposing themselves to a video camera.

Disadvantages of asynchronous teledermatology

The only disadvantage of asynchronous telehealth in dermatology is that it doesn’t happen in real-time, therefore patients can’t ask any follow-up questions and get an immediate response. 

However, with a store and forward platform telehealth platform patients can send written questions to their dermatology providers and get answers in a couple of days which removes this point as a disadvantage. 

3. Hybrid teledermatology

Hybrid teledermatology (also known as mixed or blended teledermatology) refers to a model of care that combines elements of both synchronous (live video conferencing) and asynchronous (store-and-forward) teledermatology. The objective of this model is to leverage the advantages of each approach to provide comprehensive and flexible dermatological care.

By offering hybrid teledermatology, patients have the option to choose between synchronous and asynchronous consultations based on their preferences or the nature of their skin condition. This approach allows for a tailored and personalized patient experience, optimizing the benefits of both real-time interactions and asynchronous communication.

Hybrid teledermatology has the potential to enhance patient satisfaction, improve access to care, reduce waiting times, and provide comprehensive dermatological services. However, it is essential to develop clear protocols and guidelines for patient selection and appropriate utilization of synchronous and asynchronous components to ensure the most efficient use of this blended approach.

Teledermatology applications

Teledermatology serves as a complementary component of comprehensive patient care, rather than a substitute for in-person doctor visits. It enables family doctors to conveniently collaborate with specialists, enabling information sharing between patients, primary care providers and specialists.

Synchronous and asynchronous teledermatology and self-monitoring tools, are employed for purposes including education, healthcare delivery, disease control, and sickness screening. 

While telemedicine may not provide solutions for every healthcare challenge, it plays a crucial role in alleviating strain on the healthcare system⁶.

Applications of teledermatology:

1. Direct consultations
2. Specialist referral
3. Online patient triage
4. Virtual prescription renewals
5. Patient follow-up care

1. Direct consultations

Patients with a skin condition can use a teledermatology system to get remote care for non-emergency skin problems. 

This usually happens through a smartphone app or web portal where patients fill in their details, write down their chief complaint, symptoms and take some high-quality photos of their skin conditions. 

Through a web portal, dermatologists can access all their patients’ requests, and if the case seems straightforward, such as in the case of acne, they can offer a diagnosis and treatment.

2. Specialist referral

Referring to a specialist is an important application in teledermatology. This technology enables information-sharing between different departments. By sharing the patient’s data and high-quality images, providers can consult with a dermatologist when they consider it necessary. 

3. Virtual triage of patients

Virtual triage in dermatology refers to the practice of using a telehealth system to assess patients online and prioritize them based on the severity of their disease and the resources available.

With store-and-forward technology, the dermatologist can review all patients’ requests as they come in and can call in patients with complicated cases for an in-person visit and others can receive care in a telehealth visit.

4. Virtual medication renewals

In most US states and countries, prescriptions can only be renewed every 6 to 12 months with an in-person consultation with the patient first. 

To renew the prescription, the provider usually asks patients a series of questions about their health and symptoms to ensure the medicine is working and not causing strong side effects. 

Telemedicine enables online prescription refills. Patients can answer a clinical questionnaire via the app or web portal, and if the provider deems it adequate,  they will refill the prescription online without the need for an in-person appointment.

5. Follow-up care

Patients with chronic skin conditions such as acne, eczema, and psoriasis often require many follow-up visits. Therefore, for patients with a confirmed diagnosis and a treatment plan in place, disease management can be even more effective with store-and-forward teledermatology. 

A teledermatology platform

The Miiskin platform offers an asynchronous telehealth solution catering to dermatology, primary care, and clinical research needs.

This solution is valuable tool for private practices, health systems, and contract research organizations. It consists of two main components: the Miiskin app for patients and the Miiskin web portal for healthcare providers. Its primary purpose is to facilitate virtual care in various ways, such as conducting patient consultations, triaging patients, handling prescription renewal visits, and providing follow-up care for patients with chronic skin conditions.

The technology brings about three significant advantages:

• Drastically reduces patient waiting times from potentially weeks to less than 48 hours.
• Offers healthcare providers increased flexibility with their schedules.
• Complements physical appointments, creating a more comprehensive and adaptable healthcare approach.

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Article References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6231765/
https://www.ncbi.nlm.nih.gov/books/NBK459382/
https://web.archive.org/web/20070202162157/http://www.atmeda.org/icot/sigtelederm.htm
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9445412/
https://www.accenture.com/us-en/insights/health/leaders-make-recent-digital-health-gains-last
https://patientengagementhit.com/news/long-wait-times-in-dermatology-harm-patient-experience-safety
https://onlinelibrary.wiley.com/doi/10.1111/pde.14479
https://www.jmir.org/2018/4/e135/
https://mhealthintelligence.com/news/asynchronous-telehealth-gives-providers-an-alternative-to-dtc-video
https://www.liebertpub.com/doi/abs/10.1089/tmj.2018.0160