This research project is in progress. PCORI will post its findings here within 90 days after our final review is complete. In the meantime, results have been published in peer-reviewed journals, as listed below.
Background: Chronic skin diseases are associated with significant physical impairments and markedly decreased quality of life. In the United States, many patients with chronic skin diseases, especially among those living in underserved or remote areas, lack regular access to dermatologic care. Consequently, these patients experience worse clinical outcomes and reduced quality of life.
Teledermatology, the remote delivery of dermatologic services and clinical information using telecommunications technology, is intended to increase access to treatment but has not achieved wide adoption. Real-world challenges in traditional consultative asynchronous settings include a lack of collaboration and informed communication among patients, primary care providers (PCPs), and dermatologists. Key limitations include patients’ lack of direct contact with specialists and insufficient support for PCPs by specialists.
In this study, we will evaluate an innovative, online specialty-care delivery model to increase access to dermatologists and improve patient outcomes. This model provides patients and PCPs direct and asynchronous online access to dermatologists for management of chronic skin diseases. This model fosters team care and patient engagement through active sharing of management plans and multidirectional, informed communication among patients, PCPs, and specialists.
Objective: Evaluate the effectiveness of this online specialty care on access to care, severity of chronic skin diseases, depression, and quality of life.
Methods: We will conduct a pragmatic trial to compare the impact of the online specialty-care model with usual in-person care. We will enroll patients with chronic skin diseases from Colorado and California. In addition to recruiting patients from the general population, we will place a specific emphasis on recruiting patients with chronic skin diseases who live in rural and underserved communities. We will analyze patient-centered outcomes to identify potential differences over time between the two models. To evaluate the utility of the online specialty-care model from patients’ and clinicians’ perspective, we will conduct key informant interviews and apply qualitative research methods.
Anticipated Impact: An online specialty-care model has important applications in many other medical and surgical specialties, where a team-based and technology-enabled model is necessary to significantly improve patient-centered outcomes.
|Article Highlight: This project, highlighted in JAMA Network Open, evaluated whether connecting patients and primary care physicians with dermatologists online was as effective as sending patients to an in-person appointment with a dermatologist. Researchers found that patients in the two groups experienced an equivalent improvement in disease severity, demonstrating that innovative telehealth delivery models can transform care access and delivery among patients with chronic illnesses.|
Results of This Project
^April W. Armstrong was affiliated with the University of Colorado Denver when this project was funded.