Teledermatology and the COVID-19 pandemic: experience from a Portuguese center

Abstract

Introduction: In order to maintain assistential activity while ensuring social distancing and mobility restrictions imposed during the COVID-19 pandemic, the Dermatovenereology Department of Hospital de Santo António dos Capuchos implemented an asynchronous teledermatology platform based on e-mail and smartphones. This study aims to evaluate its application to urgent outpatient and inpatient consultations while considering its benefits and limitations. Methods: All written communications received via e-mail or smartphone between April 1, 2020 and April 31, 2021 were reviewed. Data was evaluated and statistical analysis was made using SPSS Statistics 25® software. Results: We reviewed 471 referrals (329 for outpatient and 142 for inpatient urgent consultations). E-mail was the most used platform (68.8%) and most referrals were composed of clinical information and clinical images (70.3%). Only 29% of these contained adequate clinical information and clinical images simultaneously. The majority of referrals received a response by a dermatologist in less than 24 hours (89%) and conversion to in-person evaluation was made in 58% of cases. The average time for in-person evaluation after triage was 0.25 days for inpatients and 4 days for outpatients. Conclusion: The COVID-19 pandemic hastened teledermatology implementation in order to maintain good healthcare. This study demonstrates that these platforms where wildly accepted by healthcare professionals and patients and remote consultations were possible in a significant percentage of cases. Teledermatology struggles with its own limitations and can never fully replace in-person evaluation, but can present itself as a useful tool in daily practice.

Keywords

• Teledermatology. COVID-19. Pandemic.