Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
Generic selectors
Exact matches only
Search in title
Search in content
Post Type Selectors
Search in posts
Search in pages
Filter by Categories
15th National Conference of the IAOMFP, Chennai, 2006
Abstract
Abstracts from current literature
Acne in India: Guidelines for management - IAA Consensus Document
Addendum
Announcement
Art & Psychiatry
Article
Articles
Association Activities
Association Notes
Award Article
Book Review
Brief Report
Case Analysis
Case Letter
Case Letters
Case Notes
Case Report
Case Reports
Clinical and Laboratory Investigations
Clinical Article
Clinical Studies
Clinical Study
Commentary
Conference Oration
Conference Summary
Continuing Medical Education
Correspondence
Corrigendum
Cosmetic Dermatology
Cosmetology
Current Best Evidence
Current Issue
Current View
Derma Quest
Dermato Surgery
Dermatopathology
Dermatosurgery Specials
Dispensing Pearl
Do you know?
Drug Dialogues
e-IJDVL
Editor Speaks
Editorial
Editorial Remarks
Editorial Report
Editorial Report - 2007
Editorial report for 2004-2005
Errata
Erratum
Focus
Fourth All India Conference Programme
From Our Book Shelf
From the Desk of Chief Editor
General
Get Set for Net
Get set for the net
Guest Article
Guest Editorial
History
How I Manage?
IADVL Announcement
IADVL Announcements
IJDVL Awards
IJDVL AWARDS 2015
IJDVL Awards 2018
IJDVL Awards 2019
IJDVL Awards 2020
IJDVL International Awards 2018
Images in Clinical Practice
Images in Dermatology
In Memorium
Inaugural Address
Index
Knowledge From World Contemporaries
Leprosy Section
Letter in Response to Previous Publication
Letter to Editor
Letter to the Editor
Letter to the Editor - Case Letter
Letter to the Editor - Letter in Response to Published Article
LETTER TO THE EDITOR - LETTERS IN RESPONSE TO PUBLISHED ARTICLES
Letter to the Editor - Observation Letter
Letter to the Editor - Study Letter
Letter to the Editor - Therapy Letter
Letter to the Editor: Articles in Response to Previously Published Articles
Letters in Response to Previous Publication
Letters to the Editor
Letters to the Editor - Letter in Response to Previously Published Articles
Letters to the Editor: Case Letters
Letters to the Editor: Letters in Response to Previously Published Articles
Media and news
Medicolegal Window
Messages
Miscellaneous Letter
Musings
Net Case
Net case report
Net Image
Net Images
Net Letter
Net Quiz
Net Study
New Preparations
News
News & Views
Obituary
Observation Letter
Observation Letters
Oration
Original Article
ORIGINAL CONTRIBUTION
Original Contributions
Pattern of Skin Diseases
Pearls
Pediatric Dermatology
Pediatric Rounds
Perspective
Presedential Address
Presidential Address
Presidents Remarks
Quiz
Recommendations
Regret
Report
Report of chief editor
Report of Hon : Treasurer IADVL
Report of Hon. General Secretary IADVL
Research Methdology
Research Methodology
Resident page
Resident's Page
Resident’s Page
Residents' Corner
Residents' Corner
Residents' Page
Retraction
Review
Review Article
Review Articles
Reviewers 2022
Revision Corner
Self Assessment Programme
SEMINAR
Seminar: Chronic Arsenicosis in India
Seminar: HIV Infection
Short Communication
Short Communications
Short Report
Snippets
Special Article
Specialty Interface
Studies
Study Letter
Study Letters
Supplement-Photoprotection
Supplement-Psoriasis
Symposium - Contact Dermatitis
Symposium - Lasers
Symposium - Pediatric Dermatoses
Symposium - Psoriasis
Symposium - Vesicobullous Disorders
SYMPOSIUM - VITILIGO
Symposium Aesthetic Surgery
Symposium Dermatopathology
Symposium-Hair Disorders
Symposium-Nails Part I
Symposium-Nails-Part II
Systematic Review and Meta-Analysis
Systematic Reviews and Meta-analyses
Systematic Reviews and Meta-analysis
Tables
Technology
Therapeutic Guideline-IADVL
Therapeutic Guidelines
Therapeutic Guidelines - IADVL
Therapeutics
Therapy
Therapy Letter
Therapy Letters
View Point
Viewpoint
What’s new in Dermatology
View/Download PDF

Translate this page into:

Miscellaneous Letter
87 (
3
); 436-437
doi:
10.25259/IJDVL_515_20
pmid:
33666059

COVID-19 pandemic ushering in the era of teledermatology

Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India

Corresponding author: Dr. Vishal Gupta, Department of Dermatology and Venereology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi - 110 029, India. doctor. vishalgupta@gmail.com

Licence
This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

How to cite this article: Taneja N, Gupta V. COVID-19 pandemic ushering in the era of teledermatology. Indian J Dermatol Venereol Leprol 2021;87:436-7.

Sir,

Since it was first reported in December 2019 in China, COVID-19 caused by the novel Corona virus SARS-CoV-2, has spread rapidly throughout the world. It was declared a pandemic by the WHO on March 11, 2020.1 In a bid to control the spread of this highly contagious infection, countries have declared ‘lock-downs’ with emphasis on social distancing. The out-patient services of many hospitals and clinics have been shut-down, with only emergency services being run. Health-care policies changed quickly to prioritize the care of COVID patients, and rightly so. In such a scenario, the care of non-COVID patients understandably took a backseat. However, as it becomes increasingly likely that such curtailments will be extended, it is important that the health-care needs of our non-COVID patients are not ignored.

Telemedicine, which can provide a potential solution to this problem, is currently almost non-existent in India. In a country like ours, where medical professionals are largely concentrated in cities and urban areas (doctor-population ratio of 0.68/1000 Indian population, with 77.4% of health workers located in urban areas), perhaps telemedicine consultation should have become the norm long back.2 Its utility has already been demonstrated in pre-COVID settings, and can be particularly advantageous during disasters and public health emergencies in rendering medical services at remote locations.3 COVID-19 pandemic also provides an opportunity to revive telemedicine. Dermatology, as a visual branch of medicine, is particularly suited to telemedicine (teledermatology).

Teledermatology services can be delivered through either real-time (RT) video consultation or as asynchronous store-and-forward (SAF) modality. In the former, the patient and dermatologist can interact through video and/or audio chat. On the other hand, in the latter, patient usually sends the image and clinical information to the dermatologist, who could reply as per convenience. While RT consultations have the advantage of allowing direct conversations between the patient and doctor (akin to face-to-face consultation), it is more time consuming, and the experience is dependent on the video/image quality, which may be variable. SAF consultations, which have a better image quality (static images), may be preferable for dermatologists. Earlier, one would require a dedicated videoconferencing set-up, available only in large hospitals, to deliver these services. Now with the advent of easy-to-use applications such as WhatsApp, Skype and Facetime, all one needs is a smartphone for a successful telemedicine consult. Patients can use these smartphone applications to make a video call to their doctors to seek medical advice. Patients can also use WhatsApp messaging service to easily send their clinical images, prior medical details and laboratory investigations to the dermatologist, who can then evaluate them and provide medical advice. The department of dermatology and venereology, All India Institute of Medical Sciences, New Delhi, is providing teleconsultation to patients since early April 2020. We contact the patients telephonically on the day of their appointment, and provide medical advice after examining the pictures of their skin lesions and previous medical records that we request the patients to send to us. Currently, we are offering teledermatology services only to our follow-up patients, as a full assessment is not required and prior relevant medical history is easily retrievable. This makes titrating the previous treatment and dose adjustments relatively easy. Providing teleconsult to a new patient can be trickier. However, follow-up patients can also have new complaints or a medical emergency which may require detailed patient examination. In such a case where a tele-advice is not possible, the patient is asked to visit a local doctor.

The medico-legal aspects of telemedicine are evolving. However, it is imperative that professional ethics observed during regular patient consults be followed for teleconsultation as well, with an emphasis on patient consent, data privacy and patient confidentiality. Recently, Ministry of Health and Family Welfare (MoHFW), in collaboration with NITI Aayog and Board of Governors (BoG), Medical Council of India (MCI), released “Telemedicine practice guidelines” for registered medical practitioners.4 The recommendations include that telemedicine consultations be charged the same fees as in-person consultations. Further, medical practitioners practicing telemedicine will have to complete a mandatory online course within three years of release of these guidelines.4

Patient satisfaction with teleconsultation also merits consideration. Though it lacks a ‘hands on’ evaluation, patients find real-time teledermatology consultations similar to in-person consultations. On the other hand, store-and-forward teledermatology does not provide a sense of personal interaction with the physician. 5 Patients’ lack of comfort in telecommunication due to technologic illiteracy and lack of access to such facilities, especially in our country, can be another deterrent. A telemedicine model where patient visits their local doctor who then discusses the case with the specialist (known as secondary teledermatology), may be better.3 Several skin conditions can be managed by a general physician who is adequately supervised by a qualified dermatologist. This could save the patient frequent long distance visits to the dermatologist, while maintaining patient-doctor interactions. Though not feasible during the current pandemic, such a model could be the way forward in future. It has the potential to decongest the tertiary care centres which are overcrowded with patients not needing advanced medical care.

Hopefully we, both doctors as well as patients, will gain confidence with the increasing use of teledermatology, which will make us more comfortable in the times to come. It is important that we do not view telemedicine as only a stop-gap measure. There is little doubt that telemedicine is here to stay and will be useful even after COVID-19. This pandemic provides us an opportunity to set the telemedicine ball rolling.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

  1. , . WHO declares COVID-19 a pandemic. Acta Biomed. 2020;91:157-60.
    [Google Scholar]
  2. , , , , , , et al. Teledermatology and its current perspective. Indian Dermatol Online J. 2020;11:12-20.
    [Google Scholar]
  3. Available from: https://www.mohfw.gov.in/pdf/Telemedicine.pdf [Last accessed on 2020 April 19]
  4. , , , , , . Patient and provider satisfaction with teledermatology. Telemed J E Health. 2017;23:684-90.
    [CrossRef] [PubMed] [Google Scholar]

Fulltext Views
3,333

PDF downloads
2,204
View/Download PDF
Download Citations
BibTeX
RIS
Show Sections