Patient and practitioner satisfaction with tele-dermatology including Australia’s indigenous population: A systematic review of the literature
Open accessAbstract
BACKGROUND: Australia's health disparity, combined with evolving technologies, has evoked increasing interest and funding in health services that could address inequities. One such emerging service is tele-medicine. OBJECTIVE: The purpose of this report is to discuss and evaluate the current literature regarding patient and practitioner satisfaction with tele-medicine, and more specifically tele-dermatology. METHODS: We searched for literature relevant to tele-dermatology use among Australia's indigenous population. We synthesized the literature in our report and identified elements of tele-dermatology not yet researched. RESULTS: Most significantly, all available research is currently based on descriptive studies and there is no validated tool to assess the efficacy of tele-dermatology. LIMITATIONS: No published research currently exists on the use of tele-dermatology among Australia's indigenous population. CONCLUSION: A review of the literature shows that tele-dermatology is considered a valuable service, particularly to patients living in rural areas who might not otherwise have access to specialist care.
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review finds tele-dermatology is generally valued, especially for rural patients, but evidence on patient and practitioner satisfaction is heterogeneous and based on descriptive studies. No published research exists on tele-dermatology use among Australia’s Indigenous population, and no validated satisfaction tool is available.
Key findings
- Diagnostic accuracy varied widely: recent studies cited 80%, but some reported accuracy as low as 43%; clinical concordance ranged from 35% to 61% for synchronous systems and 41% to 95% for asynchronous systems.
- Patient satisfaction was mixed: one study reported 100% would recommend tele-dermatology, while another found 38% preferred face-to-face consultation; most publications cited patient satisfaction around 80%, and Hsueh et al. reported 66% preferred tele-dermatology and 83% would recommend it.
- Practitioner satisfaction was consistently greater than patient satisfaction; 85% of GPs reported increased dermatology knowledge after tele-consults, and dermatologists noted tele-dermatology decreased face-to-face referrals by up to 74%.
- Economic findings were mixed: a 3-year analysis of 248 patients found tele-dermatology cost £29,700 versus £42,160 for face-to-face referral, saving £12,460; a 9-month randomized trial of 391 patients found tele-dermatology was US$82 less expensive per patient, but other work questioned cost-effectiveness.
- No published research exists on tele-dermatology among Australia’s Indigenous population; a MEDLINE search combining telemedicine, Australia, and indigenous returned only eight results, none specifically on Indigenous tele-dermatology.
Methods
- Systematic literature review and narrative synthesis of literature relevant to tele-dermatology use among Australia’s Indigenous population, including patient and practitioner satisfaction, efficacy, economics, and privacy.
- The authors searched MEDLINE using terms including telemedicine, Australia, and indigenous, which yielded eight results; none related specifically to Indigenous tele-dermatology.
- The review synthesized available descriptive studies and identified elements of tele-dermatology not yet researched, including the need for a validated survey instrument.
Limitations
- Stated in the paper: no published research currently exists on tele-dermatology among Australia’s Indigenous population; all available research is based on descriptive studies, and there is no validated tool to assess tele-dermatology efficacy.
- Evident from the text: search strategy, inclusion/exclusion criteria, and formal quality appraisal are not fully reported, and the review relies on heterogeneous descriptive studies rather than randomized controlled trials with larger sample sizes.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
0 of 32 cited sources checked · 0 supported · 0 flagged
- Findingnone given
All available research on tele-dermatology is currently based on descriptive studies.
“Most significantly, all available research is currently based on descriptive studies and there is no validated tool to assess the efficacy of tele-dermatology.”
- Also stated in: § Conclusion · plain
“Currently, available literature is based entirely on descriptive studies.”
Quote in the paperSubstantial claim - Also stated in: § Conclusion · plain
- Findingreasoning
There is no validated tool to assess the efficacy of tele-dermatology.
“Most significantly, all available research is currently based on descriptive studies and there is no validated tool to assess the efficacy of tele-dermatology.”
- Also stated in: § Conclusion · plain
“including the development of a validated survey instrument to assess tele-dermatology provider and patient satisfaction with the service.”
Quote in the paperSubstantial claim - Also stated in: § Conclusion · plain
- Findingnone given
In the majority of available literature assessing participant satisfaction with tele-dermatology, practitioner satisfaction was consistently greater than patient satisfaction.
“In the majority of available literature assessing participant satisfaction with tele-dermatology, practitioner satisfaction was consistently greater than patient satisfaction.”
Quote in the paperNot a substantial claim - Findingown data
No published research currently exists on the use of tele-dermatology among Australia's indigenous population.
“No published research currently exists on the use of tele-dermatology among Australia’s indigenous population.”
- Also stated in: § Tele-dermatology among Australia’s indigenous populations · plain
“No published research currently exists on the use of tele-dermatology among Australia’s indigenous population.”
Quote in the paperSubstantial claim - Also stated in: § Tele-dermatology among Australia’s indigenous populations · plain
- Findingcitation
Patient satisfaction rates with tele-dermatology are approximately 80% in the majority of publications.
“The latter statistic is better aligned with the majority of publications citing patient satisfaction rates at approximately 80%.”
Quote in the paperNot a substantial claim
- Interpretationreasoning
There is potential for tele-dermatology to be successfully implemented among Australia's indigenous communities.
“Studies such as this support the idea there is potential for tele-dermatology to be successfully implemented among Australia’s indigenous communities.”
Quote in the paperSubstantial claim- Rests on an assumption: Findings from other tele-medicine specialties (e.g., tele-oncology, ENT, tele-ophthalmology) are informative about the potential for tele-dermatology among Australia’s indigenous population.
- Interpretationreasoning
Tele-dermatology is considered a valuable service, particularly to patients living in rural areas who might not otherwise have access to specialist care.
“A review of the literature shows that tele-dermatology is considered a valuable service, particularly to patients living in rural areas who might not otherwise have access to specialist care.”
- Also stated in: § Conclusion · plain
“A review of the literature shows that tele-dermatology is considered a valuable service, particularly to patients living in rural areas who might not otherwise have access to specialist care.”
Quote in the paperSubstantial claim- Rests on an assumption: Patient and practitioner satisfaction is a valid measure of the value or efficacy of tele-dermatology.
- Also stated in: § Conclusion · plain
- Premisecitation
Tele-dermatology offers an educational benefit to GPs, with 85% of GPs reporting increased knowledge of dermatology following tele-consults.
“Tele-dermatology offers an educational benefit to GPs, as evidenced by van der Heijden et al. (2011) who found that 85% of GPs reported increased knowledge of dermatology following tele-consults.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites van der Heijden et al., 2011 source
Not checked in the free run.
- Interpretationcitation
Image quality is critical to improve diagnostic accuracy in tele-dermatology.
“Good quality dermatological images are critical to improve diagnostic accuracy.”
Quote in the paperSubstantial claim - Premisecitation
In 66% of cases, the treating dermatologist was unable to offer a confident diagnosis and required higher quality images.
“A 2-year study published in 2012 reported that in 66% of cases, the treating dermatologist was unable to offer a confident diagnosis and require higher quality images (Lasierra et al., 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Lasierra et al., 2012 source
Not checked in the free run.
- Premisecitation
Asynchronous tele-dermatology is significantly more convenient than synchronous tele-dermatology because the treating dermatologist has discretion to schedule an appropriate consultation time.
“Asynchronous tele-dermatology is considered significantly more convenient than synchronous because the treating dermatologist has the discretion to schedule an appropriate consultation time (Lim et al., 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Lim et al., 2012 source
Not checked in the free run.
- Premisecitation
Privacy and confidentiality are not common patient complaints when evaluating tele-dermatology.
“Privacy and confidentiality are not common patient complaints when evaluating tele-dermatology (Weinstock et al., 2002).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Weinstock et al., 2002 source
Not checked in the free run.
- Premisecitation
Tele-dermatology decreases the number of face-to-face referrals by up to 74%.
“dermatologists also noted that tele-dermatology decreased the number of face-to-face referrals by up to 74% (van der Heijden et al., 2011).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites van der Heijden et al., 2011 source
Not checked in the free run.
- Premisecitation
The primary complaint from those involved with asynchronous tele-dermatology is that image quality is often not sufficient.
“The primary complaint from those involved with asynchronous tele-dermatology is that image quality is often not sufficient.”
Quote in the paperNot a substantial claim - Premisecitation
Diagnostic accuracy increased from 66% with images of poor quality to 87% with images of adequate quality.
“Baba et al. (2005), who conducted a 3-month study in 2003 and found that diagnostic accuracy increased from 66% with images of poor quality to 87% with images of adequate quality.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Baba et al., 2005 source
Not checked in the free run.
- Premisecitation
Patients who regularly required dermatologic care (more than twice in a 12-month period) were much more likely to pursue conventional consultations.
“Additionally, a 2007 study by Mofid et al. discovered that patients who regularly required dermatologic care (i.e., more than twice in a 12-month period) were much more likely to pursue conventional consultations.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Mofid et al., 2007 source
Not checked in the free run.
- Premisecitation
100% of patients involved in one study would recommend tele-dermatology to others.
“One publication reported that 100% of patients involved in the study would recommend tele-dermatology to others (Livingstone and Solomon, 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Livingstone and Solomon, 2015
Not checked in the free run.
- Premisecitation
Tele-dermatology ranged from a cost-saving strategy to an intervention incurring greater costs than conventional care depending on the health care setting and economic perspective.
“Whited (2006) reported that tele-dermatology ranged from a cost-saving strategy to an intervention incurring greater costs than conventional care depending on the health care setting and economic perspective.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Whited, 2006 source
Not checked in the free run.
- Premisecitation
A 9-month randomized clinical trial with 391 patients found that from a societal perspective, a tele-dermatology appointment was US$82 less expensive per patient than a conventional referral.
“This 9-month randomized clinical trial with 391 patients found that from a societal perspective, a tele-dermatology appointment was US$82 less expensive per patient than a conventional referral (Datta et al., 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Datta et al., 2015 source
Not checked in the free run.
- May combine two claims. 12
- Classified as probably not a substantial claim. 10
May combine two claims.
FindingcitationDiagnostic accuracy of tele-dermatology varies widely, with reported rates as high as 80% and as low as 43%.
“Research indicates it is an efficient and appropriate health service, with two of the most recently published studies citing the accuracy of diagnosis rates at 80% (Wilson and Maeder, 2015). However, some studies have reported the diagnostic accuracy of tele-dermatology as low as 43% (Lasierra et al., 2012).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
FindingcitationFactors repeatedly associated with practitioner satisfaction with tele-dermatology include effective pre-selection of patients, use of high quality images, dermoscopy for pigmented lesions, appropriate infrastructure, and access to continued educational courses.
“Some factors have been repeatedly associated with practitioner satisfaction with tele-dermatology, including effective pre-selection of patients for tele-consultation, use of high quality images, dermoscopy for pigmented lesions, appropriate infrastructure, and access to continued educational courses (Landow et al., 2014, McFarland et al., 2013).”
Quote in the paperNot a substantial claim0 of 2 sources checkedMay combine two claims.
FindingcitationClinical concordance rates for tele-dermatology vary from 35% to 61% for synchronous systems and from 41% to 95% for asynchronous systems.
“Similarly, clinical concordance rates vary from 35% (See et al., 2005) to 61% (Thind et al., 2011) for synchronous systems, and from 41% to 95% (Whited, 2006) for asynchronous systems.”
Quote in the paperNot a substantial claim0 of 3 sources checkedProbably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.
FindingcitationFew studies effectively analyzed the economic validity of tele-dermatology, and more randomized control trials with larger sample sizes and appropriate tools of measurement must be completed before accurate conclusions can be made.
“de la Torre-Diez et al. found that few studies effectively analyzed the economic validity of tele-dermatology. They concluded that a need for more randomized control trials with larger sample sizes and appropriate tools of measurement must be completed before accurate conclusions can be made.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites de la Torre-Diez et al., 2015 source
Not checked in the free run.
May combine two claims.
InterpretationcitationTele-dermatology is an efficient and appropriate health service.
“Research indicates it is an efficient and appropriate health service, with two of the most recently published studies citing the accuracy of diagnosis rates at 80% (Wilson and Maeder, 2015).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites Wilson and Maeder, 2015 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).
Interpretationnone givenTele-dermatology will never replace the role of conventional face-to-face consultations, particularly for the assessment and management of specific dermatological conditions.
“There is no doubt that tele-dermatology will never replace the role of conventional face-to-face consultations, particularly for the assessment and management of specific dermatological conditions.”
Quote in the paperNot a substantial claimProbably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).
PremisecitationTele-dermatology reduces costs over time compared to regular consultation methods.
“Despite these expenses, many researchers have argued that the implementation and maintenance of tele-dermatology programs reduces costs over time compared to regular consultation methods.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationTele-medicine is an effective means to provide health care to remote village populations in countries outside Australia, with positive results demonstrated in Canada, Chile, and Alaska, USA.
“This notion is further supported by international research that found tele-medicine to be an effective means to provide health care to remote village populations in countries and outside Australia. Positive results have been demonstrated in Canada, Chile, and Alaska, USA among others (Gatica et al., 2015, Muttitt et al., 2004, Smith and Ferguson, 2004).”
Quote in the paperNot a substantial claim0 of 3 sources checked- cites Gatica et al., 2015
Not checked in the free run.
- cites Muttitt et al., 2004 source
Not checked in the free run.
- cites Smith and Ferguson, 2004
Not checked in the free run.
Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing). May combine two claims.
PremisecitationTele-ophthalmology could one day be a useful tool to provide health care services in remote communities but further investigations and financial incentives would be required.
“Although the publication did not report positively on tele-medicine, it did conclude that tele-ophthalmology could one day be a useful tool to provide health care services in remote communities but that further investigations and financial incentives would be required (Johnson et al., 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Johnson et al., 2015 source
Not checked in the free run.
Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).
PremisecitationDue to high sensitivity and low specificity of tele-dermatology, there are excess referrals to the service.
“Other dermatologists reported that due to the high sensitivity and low specificity of tele-dermatology, there were excess referrals to the service (Wilson and Maeder, 2015).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Wilson and Maeder, 2015 source
Not checked in the free run.
May combine two claims.
PremisecitationSynchronous tele-dermatology provides increased interaction between patient and dermatologist and closely resembles a face-to-face dermatology consultation.
“The primary advantage of synchronous tele-dermatology systems is the increased interaction between patient and dermatologist, and closely resembles a face-to-face dermatology consultation.”
Quote in the paperNot a substantial claimMay combine two claims.
PremisecitationA community-based tele-health screening service for indigenous children in Australia focusing on ENT conditions had a 76% acceptance rate by the indigenous community and tele-medicine was a useful tool in assessment and management of ENT conditions.
“The research concluded there was a 76% acceptance rate by the indigenous community, measured by the number of parents who consented for their children to be screened, and that tele-medicine was a useful tool in the assessment and management of ENT conditions.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Elliott et al., 2010 source
Not checked in the free run.
Classified as probably not a substantial claim.
Premisenone givenSix core values have been identified for indigenous culture: reciprocity, respect, equality, responsibility, survival and protection, and spirit and integrity.
“Although there is great diversity across different indigenous communities, six core values have been identified: reciprocity, respect, equality, responsibility, survival and protection, and spirit and integrity.”
Quote in the paperSubstantial claimProbably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationTele-oncology among indigenous populations found that 87% of patients were satisfied with the service.
“For example, a paper reported on the use of tele-oncology among indigenous populations, which found that 87% of patients were satisfied with the service (Mooi et al., 2012).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Mooi et al., 2012 source
Not checked in the free run.
May combine two claims.
PremisecitationA 3-year retrospective analysis of 248 patients found referring all patients directly to face-to-face dermatology cost £42,160, while setting up and using tele-dermatology cost £29,700, saving £12,460 over 3 years.
“Livingstone and Solomon (2015) conducted a 3-year retrospective analysis of 248 patients and reported that referring all patients directly to a face-to-face dermatology appointment cost £42,160. Setting up and using tele-dermatology for all 248 patients cost £29,700, saving £12,460 over the 3-year period.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Livingstone and Solomon, 2015
Not checked in the free run.
May combine two claims.
PremisecitationThe use of personal smartphones and devices for clinical photography in Australian hospitals is common practice and privacy practice and policy is inconsistent and inadequate.
“The studies reported that the use of personal smartphones and devices was common-practice and privacy practice and policy was inconsistent and inadequate (Burns and Belton, 2013).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Burns and Belton, 2013 source
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Classified as probably not a substantial claim.
InterpretationcitationThe lack of research on the use of tele-dermatology among Australia's indigenous populations is particularly significant given the unique indigenous culture recognized in the National Statement on Ethical Conduct in Research Involving Humans.
“The lack of research on the use of tele-dermatology among Australia’s indigenous populations is particularly significant given the unique indigenous culture recognized in the National Statement on Ethical Conduct in Research Involving Humans (National Health and Medical Research Council, 2015).”
Quote in the paperSubstantial claim0 of 1 sources checked- cites National Health and Medical Research Council, 2015
Not checked in the free run.
May combine two claims.
PremisecitationAsynchronous tele-dermatology is the least expensive option but also the least effective one.
“The study also demonstrated that while asynchronous tele-dermatology is the least expensive option, it is also the least effective one (Loane et al., 2000).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Loane et al., 2000 source
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Probably not a substantial claim: may not pass S3 (load-bearing).
PremisecitationTo achieve economic validity of tele-dermatology, the system should only be used for cases with a high probability of preventing a live consultation.
“Eminovic et al. (2010) concluded that in order to achieve the economic validity of tele-dermatology, the system should only be used for cases with a high probability of preventing a live consultation.”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Eminovic et al., 2010 source
Not checked in the free run.
Probably not a substantial claim: may not pass S3 (load-bearing).
Premisecitation38% of patients would prefer a face-to-face consultation to discuss their condition with a dermatologist.
“This conflicts, however, with other research stating that 38% of patients would prefer a face-to-face consultation to discuss their condition with a dermatologist (Collins et al., 2004).”
Quote in the paperNot a substantial claim0 of 1 sources checked- cites Collins et al., 2004 source
Not checked in the free run.
The paper relies on this without support.
Patient and practitioner satisfaction is a valid measure of the value or efficacy of tele-dermatology.
“A review of the literature shows that tele-dermatology is considered a valuable service, particularly to patients living in rural areas who might not otherwise have access to specialist care.”
The paper relies on this without support.
Findings from other tele-medicine specialties (e.g., tele-oncology, ENT, tele-ophthalmology) are informative about the potential for tele-dermatology among Australia’s indigenous population.
“Studies such as this support the idea there is potential for tele-dermatology to be successfully implemented among Australia’s indigenous communities.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Many countries have tested the use of telemedicine in dermatology as a way to increase access to health care services when distance is a critical factor.
“Many countries have tested the use of telemedicine in dermatology as a way to increase access to health care services when distance is a critical factor [18-26].”
From Use of Smartphones for Early Detection of Melanoma: Systematic Review (2018) · cites this paper as [21]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Lasierra study duration differs from cited reference title
MinorThe text calls the Lasierra et al. study a 2-year study, while the cited reference describes a three-year teledermatology experience.
“A 2-year study published in 2012 reported that in 66% of cases, the treating dermatologist was unable to offer a confident diagnosis and require higher quality images (Lasierra et al., 2012).”
“19. Lasierra N Alesanco A Gilaberte Y Magallon R Garcia J Lessons learned after a three-year store and forward teledermatology experience using internet: Strengths and limitations Int J Med Inform 81 5 2012 332 343 22425394”
Literature described as entirely descriptive despite randomized trials
MinorThe paper says the available literature is based entirely on descriptive studies, but its economics section describes a randomized clinical trial and another study of randomized patients.
“Currently, available literature is based entirely on descriptive studies.”
“This 9-month randomized clinical trial with 391 patients found that from a societal perspective, a tele-dermatology appointment was US$82 less expensive per patient than a conventional referral (Datta et al., 2015).”
The citation lists haven’t been fetched yet
References 38 · Cited by 31
Research works printed but not linked: 1
- Indraratna, 2011, Telemedicine: The possibilities, practicalities and pitfalls, Aust Med Stud J, 2, 11
- Authors
- Kozera, E. K., Yang, A., & Murrell, D. F.
- Affiliations
- The University of Sydney (AU)
- UNSW Sydney (AU)
- Corresponding author
- Murrell, Dedee F.
- Venue
- International Journal of Women's Dermatology
- Published
- 2016-09
- Volume
- 2
- Issue
- 3
- Pages
- 70-73
- ISSN
- 2352-6475 (ISSN-L)
- PMC
- PMC5418871
- OpenAlex
- W2518162452
- Cited by
- 31
- References
- 38
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 7 · 2021: 4 · 2020: 6 · 2019: 3 · 2018: 1 · 2017: 1 · 2015: 1
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- International Journal of Women’s Dermatology (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- University of New South Wales
- National Institute on Minority Health and Health Disparities
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Health Sciences › Medicine › Oncology › Cutaneous Melanoma Detection and Management
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Keywords
- teledermatology, telemedicine, patient satisfaction, practitioner satisfaction, Indigenous Australians, health disparities, dermatology
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