Dermatological diagnostic acumen improves with use of a simple telemedicine system for underserved areas of South Africa
Open accessAbstract
OBJECTIVE: Telemedicine holds promise as a tool for improving the delivery of specialty care, especially in underserved regions, including those in South Africa. However, data that demonstrate the extent of its sustainable benefits to referring providers are currently insufficient. This study investigates whether utilization of a teledermatology network enhances the diagnostic acumen of primary care providers (PCPs) in underserved areas of South Africa. MATERIALS AND METHODS: A longitudinal descriptive pilot study was conducted after establishing a telemedicine network linking University of Cape Town dermatology consultants to six providers from five underserved primary care sites using store-and-forward technology between October 2004 and January 2007. Of 120 total referrals, trend analysis was performed using 72 sets of patient histories, digital images, and corresponding consultant responses to evaluate the diagnostic concordance between six PCPs and teleconsultants over 12 consecutive referrals. RESULTS: Strong positive Spearman rank-order correlations were observed between the number of referrals sent per PCP and proportion of primary diagnostic agreement with teledermatologists, rs=0.86 (p <0.001). The mean primary diagnostic concordance trend that started at 13% for the first four referrals increased nearly fourfold after referring as few as nine patients to the network. CONCLUSIONS: If a simple and inexpensive teledermatology solution is carefully implemented in a resource-limited setting, an improvement of PCP diagnostic acumen can be achieved with a relatively small number of referrals. This educational benefit to referring PCPs could be sustainable and would ultimately enhance the quality of dermatological care in these underserved regions.
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In SADC, high cost of telemedicine services (e.g., excessive billing) is a major barrier for patients, negatively affecting technology usage.
“Also, the high-cost of telemedicine services (e.g., excessive billing) was viewed as a major barrier for patients (Colven et al., 2011; Kekana et al., 2010), hence negatively affecting technology usage.”
From Telemedicine use in Sub-Saharan Africa: Barriers and policy recommendations for Covid-19 and beyond (2021) · cites this paper as Colven et al., 2011
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- Authors
- Colven, R., Shim, M.-H. M., Brock, D., & Todd, G.
- Affiliations
- University of Cape Town (ZA)
- University of Washington (US)
- Corresponding author
- Colven, Roy
- ORCID
- Todd, Gail
- Venue
- Telemedicine and e-Health
- Publisher
- SAGE Publications
- Published
- 2011-06
- Volume
- 17
- Issue
- 5
- Pages
- 363-369
- ISSN
- 1530-5627 (ISSN-L)
- 1556-3669
- PMC
- PMC3109076
- OpenAlex
- W1997619729
- Cited by
- 52
- References
- 18
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 2 · 2020: 4 · 2019: 8 · 2018: 3 · 2017: 3 · 2016: 2 · 2015: 6 · 2014: 6 · 2013: 5 · 2012: 4
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Telemedicine Journal and e-Health (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Academy of Dermatology
- US-UK Fulbright Commission
- University of Cape Town
- National Institutes of Health
- Medical Research Council
- National Center for Research Resources (T32RR023256)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Telemedicine and Telehealth Implementation
- Social Sciences › Business, Management and Accounting › Organizational Behavior and Human Resource Management › Healthcare Systems and Technology
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Digital Imaging in Medicine
- Keywords
- teledermatology, store-and-forward telemedicine, primary care providers, diagnostic agreement, dermatological diagnosis, underserved areas, resource-limited settings, referral patterns, continuing medical education, South Africa
- MeSH terms
- Adult, Female, Humans, Longitudinal Studies, Male, Pilot Projects, Referral and Consultation, Skin Diseases, South Africa, Telemedicine, Rural Health Services, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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