Limited Access to Dermatology Specialty Care: Barriers and Teledermatology
Keywords:
Barriers, Teledermatology, Melanoma, Non-Melanoma, Skin CancerAbstract
Introduction: Access to dermatology specialty care is limited in the underserved population. Barrier identification and exploring the potential role of teledermatology are the first steps to address this problem.
Objectives: Identify the barriers to dermatologist care for diagnosis and treatment of melanoma and non-melanoma skin cancers in the underserved population. Additionally explored was the potential role of teledermatology to provide dermatology care access in the underserved population.
Methods: A quantitative descriptive study was conducted via an online survey instrument. The survey’s barriers portion was adapted from the 1998 Ohio Family Health Survey (OFHS). The survey’s teledermatology portion was adapted from the McFarland Teledermatology Provider and Imaging Technician Satisfaction Survey. The participants were practicing dermatologists and members of Georgia, Missouri, Oklahoma, and Wisconsin dermatology associations. Thirty-eight responded to demographic questions, of which twenty-two responded to the survey items.
Results: The top three barriers ranked as the most concerning were continually uninsured (n = 8; 36.40%), resides in a medically underserved county (n = 5; 22.70%), and family under federal poverty level (n = 7; 33.30%). Teledermatology as a potential role for access to care was supported by convenient delivery of healthcare (n = 6; 72.70%), an addition to regular patient care (n = 20; 90.90%), and increase to patient care access (n = 18; 81.80%).
Conclusion: Barrier identification and teledermatology access to provide care to the underserved population is supported. Further teledermatology research is necessary to address the logistics regarding how to initiate and deliver teledermatology to the underserved.
References
Vaidya T, Zubritsky L, Alikhan A, et al. Socioeconomic and geographic barriers to dermatology care in urban and rural US populations. Journal of the American Academy of Dermatology. 2017;78(2):406-408. https://doi.org/10.1016/j.jaad.201707.050.
Jacobsen AA, Galvan A, Lachapelle CC, et al. Defining the need for skin cancer prevention education in uninsured, minority, and immigrant communities. JAMA Dermatology. 2016;152(12):1342. https://doi.org/10.1001/jamadermatol.2016.3156.
Yadav G, Goldberg HR, Barense MD, et al. A cross sectional survey of population-wide wait times for patients seeking medical vs. cosmetic dermatologic care. PLOS ONE. 2016;11(9): e0162767. https://doi.org/10.1371/journal.pone.0162767.
Glazer AM, Rigel DS. Analysis of trends in geographic distribution of US dermatology workforce density. JAMA Dermatology. 2017; 153(5): 472. https://doi.org/10.1001/jamadermatol.2016.6032.
Buster KJ, Stevens EI, Elmets CA. Dermatologic health disparities. Dermatologic Clinics. 2012;30(1):53-59. https://doi.org/10.1016/j.det.2011.08.002.
Leavitt ER, Kessler S, Pun S, et al. Teledermatology as a tool to improve access to care for medically underserved populations: A retrospective descriptive study. Journal of the American Academy of Dermatology. 2016;75(6):1259-1261. https://doi.org/10.1016/j.jaad.2016.07.043.
Apalla Z, Lallas A, Sotiriou E, et al. Epidemiological trends in skin cancer. Dermatology Practical & Conceptual. 2017;7(2).
Sample size table. (n.d.). Retrieved from http://researchadvisors.com/tools/SampleSize.htm.
Litaker D, Koroukian SM, Love TE. Context and healthcare access: Looking beyond the individual. Medical Care4. 2005;3(6):531-540. https://doi.org/10.1097/01.mlr.0000163642.88413.58.
McFarland LV, Raugi GJ, Reiber GE. Primary care provider and imaging technician satisfaction with a teledermatology project in rural Veterans Health Administration clinics. Telemedicine and e-Health. 2013;19(11):815-825. https://doi.org/10.1089/tmj.2012.0327.
Campagna M, Naka F, Lu J. Teledermatology: An updated overview of clinical applications and reimbursement policies. International Journal of Women’s Dermatology. September 2017;3(3):176-179. https://doi.org/10.1016/j.ijwd.2017.04.002
Nelson CA, Takeshita J, Wanat KA, et al. Impact of store-and-forward (SAF) teledermatology on outpatient dermatologic care: A prospective study in an underserved urban primary care setting. Journal of the American Academy of Dermatology. 2016;74(3):484-490.e1. https://doi.org/10.1016/j.jaad.2015.09.058.
Pasquali P, Sonthalia S, Moreno-Ramirez D, et al. Teledermatology and its current perspective. Indian Dermatology Online Journal. 2020;Jan-Feb;11(1):12-20. https://doi.org/10.4103/idoj.IDOJ_241_9
Fludiona N, Jun L, Porto A, et al. Impact of dermatology eConsults on access to care and skin cancer screening in underserved populations: A model for teledermatology services in community health centers. Journal of the American Academy of Dermatology. 2018;78(2):293-302. https://doi.org/10.1016/j.jaad.2017.09.017
Skudalski L, Waldman R, Kerr P, et al. Melanoma: How and when to consider clinical diagnostic technologies. Journal of the American Academy of Dermatology. 2022;86(3):503-512. https://doi.org/10.1016/j.jaad.2021.06.90
Downloads
Published
Issue
Section
License
Copyright (c) 2022 Darlla Duniphin

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Dermatology Practical & Conceptual applies a Creative Commons Attribution License (CCAL) to all works we publish (http://creativecommons.org/licenses/by-nc/4.0/). Authors retain the copyright for their published work.

