ABSTRACT
BACKGROUND: Electronic medical records (EMRs) can be of great use in dermatological data recording. Unfortunately, not many studies have been carried out in this specific area. AIMS: We attempt to evaluate the use of an EMR system in dermatology, comparing it with a conventional paper-based system. METHODS: Two hundred patient records of patients attending the dermatology outpatient department were studied over a 3-month period. Half the reports were entered in the conventional paper-based format while the other half was entered in an EMR system. The time taken for each consultation was recorded and the same was carried out for the first subsequent follow-up visit. RESULTS: The average time taken for the completion of the EMR-based consultation for new cases was 19.15 min (range, 10-30 min; standard deviation, 6.47). The paper-based consultation had an average time of 15.70 min (range, 5-25 min; standard deviation, 6.78). The P-value (T-test was used) was 0.002, which was significant. The average time taken for consultations and entering progress notes in the follow-up cases was slightly less than 10 min (9.7) for EMR while it was slightly more than 10 min (10.3) for the paper format. The difference was not statistically significant. The doctors involved also mentioned what they felt were the advantages and disadvantages of the system along with suggestions for improvement. CONCLUSION: The use of an EMR system in dermatology (or for that matter in any specialty) may overawe most users at the beginning, but once a comfort level is established, EMR is likely to outscore conventional paper recording systems. More time-motion-case studies are required to ascertain the optimal usage of EMR systems.
ABSTRACT
BACKGROUND AND AIMS: Teledermatology is an area that has shown rapid growth in the recent past. However, not many studies have been conducted with regards to the application of teledermatology in India. Aim of our study was to evaluate the clinical profiles of cases referred for teledermatology consultation at our center, and to assess and compare the different modalities of teledermatology consultations done at our center along with the practical issues related to such a service. METHODS: A retrospective study of teledermatology consultations at our center over a 3-year period was carried out. Store-and-forward (SAF), realtime consults (RTC), and hybrid (combining the two) were included.Two trained dermatologists were involved in carrying out the consultations in the referral center. RESULTS: Of the 120 consultations, 68 male and 52 female patients in the age range of 2-77 years were seen. In more than 90% of the cases, teleconsultation was the first contact for the patient with the dermatologist (for the present condition). In 68% of the cases, the reference was for both diagnosis and management, while in the rest, the reference was mainly related to management issues (appropriate diagnosis having already been made). Certainity of diagnosis was maximum for hybrid, SAF, and RTC. CONCLUSIONS: Teledermatology can prove valuable as a tool to provide healthcare in areas of shortage of specialists. A hybrid system combining SAF and RTC could be the ideal form of teledermatology consultations in the future. Many practical issues need to be addressed before the effectiveness of teledermatology in India can be fully recognized.
ABSTRACT
Digital photography has virtually replaced conventional film photography as far as clinical imaging is concerned. Though most dermatologists are familiar with digital cameras, there is room for improvement in the quality of clinical images. We aim to give an overview of the basics of digital photography in relation to dermatology, which would be useful to a dermatologist in his or her future clinical practice.