Patient Preferences for Telemedicine Versus In-Person Dermatology Visits

Researchers assessed patient preferences between real-time teledermatology (RTTD) and in-person visits and found that the main concern with teledermatology was the potential for communication breakdown. The results of the study were published as part of the American Academy of Dermatology Virtual Meeting Experience 2020.

The study included adult patients seen by the same dermatologist via RTTD and/or in person at the Nantucket Cottage Hospital from 2011 to 2015. Researchers conducted qualitative interviews, and the resulting major themes informed a cross-sectional survey that was mailed to eligible patients. 

Most patients reported comfort in seeking RTTD for follow-up visits with doctors with whom they had an established relationship. For a new spot or rash, 68% and 65% of respondents, respectively, said they would prefer an in-person visit, while 34% said they would prefer RTTD for a follow-up visit. One respondent said, “When I think about the physicians I do have long-term relationships with, I wouldn’t mind RTTD. I wouldn’t care at all if that visit was in person or not once they’ve established a relationship.”

Most patients (89%) agreed or strongly agreed that RTTD provided convenience for those in remote settings. “The availability of the appointment to me is more important than seeing someone eye to eye,” said one respondent.

While 80% said they agreed or strongly agreed that they feel they have their doctor’s full attention during in-person visits, only 67% said the same for RTTD visits.

“Good communication between the doctor, nurse, and patient is key with RTTD,” said one participant. Most patients (63%) agreed or strongly agreed that more oral cues and instructions would be helpful during RTTD. In addition, most participants (65%) agreed or strongly agreed that they would like to receive more information about RTTD before the first visit. “I didn’t know how long the visit would be or how close the camera would get—a lot of little things I didn’t know added up to make me feel uncomfortable,” said one participant of the first-time RTTD process.

The researchers called for the establishment of a set of best practices to guide dermatologists through teledermatology care.

The study is limited by its use of only one clinical site.

Tung JK, LaChance A, Hale TM, et al. Factors affecting patient preferences between teledermatology and traditional face-to-face dermatology encounters. Presented during the AAD Virtual Meeting Experience 2020, June 12-14, 2020.