|Service||Country||Title & Authors||Publication|
|Mobile Teledermatology||US (University of California Davis, Dermatology)||Evaluation Criteria for Mobile Teledermatology Applications
and Comparison of Major Mobile Teledermatology
Applications (Ho, Baran; University of California, San Diego, School of Medicine, Lee, Michael; University of California, Davis, Dermatology, Armstrong, April; University of California Davis, Dermatology) Summary: Both AccessDerm version 1.0 (Vignet Corp., McLean, VA) and ClickMedix version 1.3 (ClickMedix LLC, Rockville, MD) were capable of managing consultations. These applications adopted different approaches to balancing image quality versus data transmission, managing follow-up patients, and enabling dialogue between providers. Conclusions: Mobile teledermatology provides convenient and scalable means of providing specialty care. The creation of mobile application evaluation criteria offers a useful guide for assessing future mobile applications.
|Telemedicine and e-Health,Volume: 19 Issue 9: September 9, 2013|
|Home-visit screening for Hansen’s Disease||US (Harvard Massachusetts Genera Hospital Department of Dermatology)||Insights on the adoption of a mobile phone based screening tool for Hansen’s Disease in Trinidad and Tobago (Kvedar, Lalla, Maloney, McKoy, Shih). Excerpts of outcome: “Our pilot suggests that the combination of clinical history and images is needed to make referral decisions and cannot be based on collecting images alone. In situations where the morphology is subtle, particular attention to variables such as lighting and background can result in photographs of a high enough resolution to relay morphology even in the community setting…”||AbstractFull manuscript to be published|
|Skin Cancer Screening*||US (University of California Davis, Dermatology)||Application of Mobile Teledermatology for Skin Cancer Screening (Armstrong A, Lamel S) Excerpts of outcome: “Use of mobile phone technology yielded high management concordance of 81% between in-person and teledermatology evaluations. This management concordance is comparable to traditional store-and-forward teledermatology where a digital camera and a computer were used for capturing and transmission of clinical images.”||Journal of American Academy of Dermatology. 2012 Oct;67(4):576-81. doi: 10.1016/j.jaad.2011.11.957. Epub 2012 Jan 13.|
|Tele-Dermatology (general)*||Egypt(Qualcomm, Mobinil, MoH, MCIT)||Mobile teledermatology in the developing world: implications of a feasibility study on 30 Egyptian patients with common skin diseases(Tran K, Ayad M, Weinberg J, Cherng A, Chowdhury M, Monir S, El Hariri M, Kovarik C)Excerpt of outcome: “Diagnostic agreement between face-to-face consultation and the two local senior dermatologists performing independent evaluation by teleconsultation was achieved in 23 of 30 (77%) and in 22 of 30(73%) cases, respectively, with a global mean of 75%…Mobile teledermatology is a technically feasible and diagnostically reliable method ofamplifying access to dermatologic expertise in poorer regions of the globe where access to computers withInternet connectivity is unreliable or insufﬁcient.”||Journal of the American Academy of Dermatology, 2011 Feb;64(2):302-9. Epub 2010 Nov 20.|
|Tele-Dermatology (no Internet setting)*||Ghana(SUNY Downstate, UPenn)||Mobile Teledermatology in Ghana(Rosen A, Osei-tutu A, Kovarik C, Siegel D, Shih T, Amanquah N, Osei-Tutu E, Haligah C, Addo H, Konnie A)Excerpt of outcome: “Diagnostic concurrence was observed in 27 out of 34 cases (79.4%). Non-concurrence was seen in 7 out of 37 cases; however all cases had similar differential diagnoses…Mobile phones may be successfully used in Ghana to capture images and patient information and relay to a website through which a remote doctor can render a diagnosis. The quality of the images taken by the mobile phone is adequate for the purposes of remote diagnosis. The introduction of mobile teledermatology to Ghana has the potential to provide a cost effective solution to improving the delivery of and access to cutaneous medical services.”||Journal of the American Academy of Dermatology
Volume 69, Issue 2 , Pages e90-e91, August 2013
|Tele-Dermatology for HIV/AIDS*||Botswana(Botswana-UPenn Partnership)||HIV+ Patients in Botswana Find Mobile Teledermatology an Acceptable Method for Receiving Dermatologic Care; The use of mobile telemedicine for remote diagnosis in HIV infected patients in Botswana(Azfar RS, Weinberg JL, Cavric G, Lee-Keltner IA, Bilker W, Gelfand JM, Kovarik CK)Excerpt of outcome: ”We hypothesize that there will be significant concordance in the diagnosis of both cervical and skin lesions in HIV patients, when comparing the diagnosis of the on-site clinician to the diagnosis of the clinician evaluating the photos through telemedicine…HIV positive patients have an increased prevalence of skin disease, including several conditions which, if present, may affect HIV management…This problem is further compounded by the severe lack of dermatologists in the region. We propose the use of mobile teledermatology evaluation as a tool to help detect skin conditions in HIV patients in sub-Saharan Africa, as well as to facilitate increased access to dermatologic care for patients with limited access to specialist physicians.||Journal of Investigative Dermatology 130: S65, 2010.|
|Tele-Oral Surgery*||Botswana(Botswana-UPenn Partnership)||The Use of Mobile (Cellular) Oral Telemedicine in Botswana(Ghose S, Littman-Quinn R, Mohutsiwa-Dibe N, Molefi T, Phuthego M, Kovarik C)Excerpt of outcome: “A total of 69 remote consultations – 43 actual, 26 test – concerning complex cases from one central and four satellite hospitals were successfully conducted between March and October of 2010, building upon institutionaland preparatory work ongoing since September, 2009…It is our contention that we have demonstrated the practical application of a mobile telemedicine approach that provides patients and practitioners with a more rapid, cost-effective, and informedmeans of care in complex cases.While this approach has been first piloted with oral medicine and oral surgery in the country of Botswana, the general framework should have utility as a model for other fields of medicine and other locations.”||mHealth Summit Poster Presentation 2010|
|Tele-Mentoring/Medical Education*||Botswana(Botswana-UPenn Partnership)||The Use of Mobile Service to Enhance Medical Education in Botswana(Chang A, Ghose S, Littman-Quinn R, Anolik R, Kyer A, Mazhani L, Seymour A, Kovarik C)Excerpt of outcome: “Between follow-up at 4 weeks and 8 weeks,residents increased their usage of the phone, which can be primarily attributed to increased opportunity for use and growing familiarity. Residents became familiar with the phone through various ways: initial training session, help from other residents, spending time alone with the phone.Some residents used the phone not only for access to point-of-care applications in the medical setting, but also for supplementary medical reading while at home. Most frequently used point-of-care applications: 5-Minute Clinical Consult, 5-Minute Pediatric Clinical Consult, ePocrates Rx.”||mHealth Summit Poster Presentation 2010|
|Cervical Cancer Screening*||Botswana(Botswana-UPenn Partnership)||Use of Mobile Telemedicine for Cervical Cancer Screening(Gormley R, Quinley K, Shih T, Szep Z, Steiner A, Ramogola-Masire D, Kovarik C)Excerpt of outcome: “Final data analysis is currently underway…We hypothesize that there will be significant concordance in the diagnosis of cervical lesions in HIV patients, when comparing the diagnosis of the on-site clinician to the diagnosis of the clinician evaluating the photos through telemedicine…Women in sub-Saharan Africa often present with advanced cervical cancer, even though precancerous lesions are detectable via cervical screening techniques. This is the result of multiple factors, including lack of screening, lack of appropriate referral, as well as HIV-HPV (human papillomavirus) co-infection. In order to improve the availability of cervical cancer screening in Botswana, we propose the use of mobile telemedicine as an adjunct tool to visual screening techniques for cervical cancer…Use of this technology has the potential to connect resource-poor cancer screening centers to remotely-located gynecologists who can diagnose lesions and direct appropriate therapy, which will help to prevent cervical cancer in Sub-Saharan Africa.”||Journal of Telemedicine and TelecareUse of Telemedicine for Cervical Cancer Screening|
* Research studies prior to May 2011 were facilitated by Click Diagnostics founder, who consequently founded ClickMedix.