Follow-up visits conducted via a secure Web site may result in similar clinical outcomes as in-person visits among patients with acne, according to a report in the April issue of Archives of Dermatology, one of the JAMA/Archives journals.
"Ensuring timely access to high-quality care is currently a challenge for the stressed U.S. health care system. Many specialties, including internal medicine, psychiatry and dermatology, are struggling to accommodate a growing demand for appointments owing to a critical shortage of health care providers," the authors write as background information in the article. Dermatology, in particular, faces challenges such as an increase in skin cancer and a work force that is not equally distributed geographically. "One potential solution to these issues may be the adoption of innovative, technology-enabled models of care delivery."
Alice J. Watson, M.B.Ch.B., M.R.C.P., M.P.H., Hagit Bergman, M.D., M.P.H., and colleagues at Center for Connected Health, Massachusetts General Hospital and Harvard Medical School, Boston, evaluated whether remote online visits and office care produced equivalent clinical outcomes among 151 patients with mild to moderate acne. Of these, 74 were assigned to carry out four follow-up visits using an e-visit platform. Every six weeks, they were prompted to send digital images of their skin and an update via a secure Web site to the dermatologist, who responded with advice and electronic prescriptions. The other 77 participants visited the dermatologists' office four times.
A total of 121 patients completed the study. The decrease in number of inflammatory acne lesions was similar between the e-visit (6.67) and office visit (9.39) groups. Both dermatologists and patients reported similar levels of satisfaction with their care regardless of the visit type. Compared with office visits, e-visits saved time for patients and did not change the amount of time dermatologists spent per patient (4 minutes and 8 seconds vs. 4 minutes and 42 seconds).
"In this trial, delivering follow-up care to subjects with mild to moderate acne via office and online visits produced equivalent clinical outcomes by several different metrics," the authors conclude. "These findings suggest that dermatologists obtain sufficient information from digital images and survey responses to make appropriate management decisions in the treatment of acne. In addition, this model of care delivery was popular with both physicians and patients, likely owing to the convenience and/or time savings associated with e-visits."
(Arch Dermatol. 2010;146:406-411. Available pre-embargo to the media at www.jamamedia.org.)
Editor's Note: This study was supported in part by a grant from the Information Systems Research Council at Partners Healthcare, Boston. Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.
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