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Telederm society's goal: Woldwide access for all

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International report - The International Society of Teledermatology (ISTD), based in Graz, Austria, seeks to establish worldwide access to teledermatology services, particularly as a tool for reaching underserved and often remote patient populations, one of its cofounders says.

"Our mission is the comprehensive promotion of teledermatology" through activities including international exchanges of teledermatology experience and expertise, says H. Peter Soyer, M.D., the not-for-profit organization's president.

Setting standards

The organization plans to complete this project in mid-to late 2007, he says. Teledermatology employs photography and technology to offer diagnosis at a distance.

At times, Dr. Soyer tells Dermatology Times, "It may happen that the image is not good enough" to support a confident diagnosis over the Web.

"In reality," he asserts, "this is less a technical problem than a human problem - sometimes doctors are unable to take good pictures."

Nonetheless, he says, "We are convinced that store-and-forward technology offers big advantages compared to real-time consultations," which often require members to coordinate across multiple time zones.

The ISTD grew out of a previous organization - the European Confederation of Telemedical Organizations in Dermatology - formed about seven years ago, says Dr. Soyer, who also serves as professor of dermatology and director of teledermatology research at the Medical University of Graz, Austria.

He says that while helping to organize the confederation's 2002 European Congress, "I realized that when one speaks of Internet-based teledermatology, it's nonsense to restrict participation to Europe."

In fact, he says, about half of the 2002 gathering's 80 attendees came from outside Europe.

At that time, "The idea was born to found the ISTD," he says.

Dr. Soyer and cofounder Gerald Gabler, an information technology expert from the Medical University of Graz, officially registered the ISTD in Graz on Feb. 7, 2003. Dr. Soyer was elected president at the ISTD's first World Congress of Teledermatology in November 2006. The next World Congress is scheduled for 2009, probably in Chennai, India, he says.

The initial ISTD gathering drew some 120 attendees from 32 countries, including the United States, China, Russia, Australia, Pakistan and Iran, Dr. Soyer says.

'No longer optional'

The World Congress illustrated that teledermatology is "no longer optional - this is the direction that dermatology will be taking in the future," says John H. Bocachica, M.D., chief, dermatology and teledermatology, Alaska Native Medical Center, Anchorage, Alaska.

"Those who are not clued in regarding how to conduct teledermatology - from the equipment to image resolution - are now finding out that they have to be," he says.

Dr. Bocachica also is an ISTD member and a frequent speaker on teledermatology.

Currently, the ISTD's 300 members include 36 from the United States, 13 from Turkey and 19 each from India and Iran, Dr. Soyer says.

"Interestingly enough," he says, "the less well-developed countries often are very keen on teledermatology" because it can help patients bypass access and infrastructure limitations they may face in their homelands.

For example, "Iran possesses a strong tradition in morphologic disciplines within medicine," he says. "Many leading pathologists currently practicing in the States are of Persian origin, and this is also true in dermatology."

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