Online follow-ups compare well with in-office care

Results of a new study suggest the extent to which new ways of delivering dermatological services could improve outcomes and ease access to care.

A research team led by April Armstrong, M.D., vice chair of clinical research at the University of Colorado Medical School, Denver, set out to compare the effectiveness of an online model for follow-up dermatologic care in atopic dermatitis patients with that of in-person office visits. They conducted a yearlong clinical trial in medically underserved areas, outpatient clinics, and the general community. Participants included children and adults with atopic dermatitis who had access to the Internet, computers and digital cameras.

After an initial in-person visit, the 156 patients were randomized either to direct-access online or traditional in-person care for follow-up management of their atopic dermatitis. Online patients captured and transmitted clinical images and history asynchronously to their dermatologists, who evaluated the information, offered recommendations and education, and prescribed medications online. Patients in the other group visited dermatologists in their offices for traditional follow-up care.

At the end of the year, more than 38 percent of the patients who received online care only achieved complete or near clearance, which compares favorably with the nearly 44 percent of in-office patients who achieved similar degrees of clearance.

“There are newer models of specialty care delivery where patients can be connected to their dermatologists from anywhere and at anytime,” Dr. Armstrong tells Dermatology Times. “How well these new models work will depend on many different factors, such as qualification of the provider and quality of communication between patients and the specialist. Under the right circumstances, the quality of care and patient outcomes delivered through online care can be the same as face-to-face office visits.”

The study was published online Oct. 22 in JAMA Dermatology.

Reference: Armstrong AW, Johnson MA, Lin S, et al. Patient-centered, direct-access online care for management of atopic dermatitis. JAMA Dermatol. 22 Oct 2014 [Epub ahead of print]. http://archderm.jamanetwork.com/article.aspx?articleid=1918745&resultClick=3