Evolving teledermatology policy and reimbursement landscape in the United States.

Background: Policymakers and payers are reevaluating the temporary telehealth flexibilities granted during the COVID-19 public health emergency, which will shape future teledermatology utilization. Objective: To summarize the recently expanded telehealth flexibilities in the United States, projected changes, and corresponding implications for dermatologists. Methods: Narrative review of the literature, United States policies and regulations, and white paper reports. Results: Key telehealth flexibilities included expansion of payment parity, relaxation of originating site requirements, loosening of state licensure requirements, and HIPAA (Health Insurance Portability and Accountability Act of 1996) enforcement discretion. These changes enabled widespread accessibility and adoption of teledermatology, which enhanced high-quality and cost-effective dermatologic care. Most waivers will end 151 days following the end of the public health emergency declaration. Notably, asynchronous telehealth was not included in the reimbursement expansion. Limitations: Only policies and regulations through December 2022 are included. Conclusion: It will be important for the field of dermatology to stay abreast of the upcoming changes in telemedicine policies and reimbursement, to demonstrate teledermatology's value through evidence-based studies and to advocate for enduring policies that will promote the accessibility of teledermatology for patients.

Patient Satisfaction in Teledermatology: an Updated Review.

Purpose of Review: Teledermatology continues to gain popularity across the world. It is crucial that dermatologists understand patient experience and satisfaction to effectively incorporate this practice into patient care. This article provides an updated review of recent findings on patient satisfaction in teledermatology. Recent Findings: Over the last 2 years, there has been an increase in studies on the patient experience of live-video teledermatology, while previous studies largely focused on store-and-forward teledermatology. This reflects the expansion of live-video teledermatology since the COVID-19 pandemic. Patients are generally very satisfied with both store-and-forward and live-video teledermatology, valuing its accessibility, quality of care, and patient-provider relationship. Decreased patient satisfaction is linked to technical difficulties, privacy concerns, lack of procedure availability, and thorough physical exams. However, teledermatology experiences are not equal across demographic groups. Access to technical support, digital literacy, age, social economic status, and type of dermatological conditions have all been found to affect patient experience. Summary: Studies show high levels of patient satisfaction in teledermatology but limitations exist. Future efforts to improve teledermatology experiences will require reducing barriers among demographics, improving patient education, investment in technology, and collaboration among all parties involved.

Problem-Based Learning in Data Science Course: Analysis of Online Learning during the Covid-19 Pandemic

This paper presents the Live Interactive Streaming Classroom (LISC) system model which can be applied to the Problem-Based Learning (PBL) and motivate students to solve problems in a real-life setting with guidance from teachers via online learning. In this study, the students used self-learning methods for interactive class. The class was managed through the online streaming system by the video conference applications. The study showed that the students' coding and real-life problem solving skills were improved from hand-on experience. The LISC system model stimulated students' learning levels. This was proved by applying the proposed method to the Data Science class at Silpakorn University, Thailand, joined by an instructor from Japan. When the course ended, the evaluation from the participating students showed that they were much satisfied that their skills were up-leveled for coding and real-life problem solving, and their attitudes towards the Data Science class improved. It implied and confirmed that the proposed method was efficient to the students' practical learning level, among the new normal living period in the Coronavirus pandemic. © 2022 ACM.

The Impact of COVID-19 on Teledermatology: A Review.

The accelerated implementation and use of teledermatology during the coronavirus disease 2019 pandemic has met with successes and challenges. This review explores how telemedicine was used in dermatology before the pandemic, the regulatory adaptions made in response to the pandemic, and the effectiveness of the rapid implementation of teledermatology during the coronavirus disease 2019 pandemic, and, finally, how teledermatology has expanded in response to the pandemic. This review examines lessons learned and how teledermatology's reliance on digital technologies might paradoxically exacerbate health care disparities, and finally, considers the future outlook.

Definitions, survey methods, and findings of patient satisfaction studies in teledermatology: a systematic review.

Remote consultations likely will grow in importance if the COVID-19 pandemic continues. This review analyzes which methods of teledermatology patients prefer by categorizing how recent studies have defined satisfaction, conducted surveys and concluded patients respond to the different modalities of teledermatology. Using PubMed and Cochrane databases, we reviewed studies from April 5th, 2010 to April 5th, 2020 that included the search terms patient satisfaction and teledermatology. All studies that included patient satisfaction as an outcome were included, but studies not published in English were excluded. We examined domains of satisfaction, survey method, study characteristics (including patient population, country, age, study design and evidence score), findings and statistical comparisons. We thoroughly reviewed 23 studies. Definitions of satisfaction varied, but all concluded patients were satisfied with the live-interactive and store-and-forward modalities. The studies reveal that store-and-forward is appropriate for clinicians with established patients who require regular follow-up. Verified areas of care include treatment of chronic conditions, topical skin cancer therapy, wound monitoring, and post-procedural follow-up. Only four studies conducted statistical analyses. One of those studies compared patient preference for each modality of teledermatology with face-to-face dermatology. While this study reported high satisfaction with each mode of teledermatology, patients still preferred face-to-face. Favorable responses to remote diagnostic capabilities suggest that these offerings improve preference for teledermatology. With only one study evaluating preference between each modality and face-to-face dermatology, more studies should address the discrepancy. Surveys that cover all domains of satisfaction may improve assessments and identify where gaps in preference exist.

Live-interactive teledermatology program in Taiwan: One-year experience serving a district hospital in rural Taitung County.

BACKGROUND/PURPOSE: Population aging and unequal accessibility of health care are increasingly important in developed countries. One strategy to overcome these issues is utilizing telemedicine, which is recently made possible technologically by the advancement of internet speed, high speed zooming cameras, and the information storages. In Taiwan, the telemedicine is granted legally by the amendment for Taiwan's Physician Act in 2018. METHODS: Kaohsiung Chang Gung Memorial Hospital (Kaohsiung CGMH) is the first hospital in Taiwan to provide the telemedicine service connecting to Cheng Kung Branch of Taitung Hospital since Nov 2018. Consultation services from Dermatology, ENT, and Ophthalmology have been delivered in the live-interactive and face to face module every week. RESULTS: Dermatology consultation comprises the majorities. In the first year, there were totally 426 dermatology consultation services. Eczema, fungal infections, and scabies infestation were the three most common diseases in the beginning. The disease diagnosis became more diverse after several months, including some ready-to-treat diseases pending correct diagnosis, such as pediculosis, psoriasis, and urticaria. Coupled with dermoscopic images, diseases such as hair loss, pediculosis capitis, skin tumor, and scabies, were diagnosed promptly. The subjective patient improvement rate was more than 75% year-round and the case closure rate was more than 85% year-round. CONCLUSION: Teledermatology is a promising approach to serve the remote medical-underprivileged regions. The teledermatology is anticipated to help underserved regions, nursing homes, prisons, and in situations with severe pandemic infections, such as COVID-19.