BACKGROUND Inpatient dermatology has been shown to improve patient outcomes at a reduced cost. Few hospitals have dermatologists available. Teledermatology may allow dermatologists to assess hospitalized patients remotely. OBJECTIVE To examine the diagnostic concordance between a hospitalist, dermatologist, and teledermatologist using store-and-forward teledermatology. METHODS For 100 consecutive patients requiring inpatient dermatology consultation, a survey was conducted by all 3 raters to convey diagnostic impressions and therapeutic recommendations. Complete and partial agreements were assessed using the Cohen kappa statistic. RESULTS Inpatient dermatology consultation often resulted in a change in diagnosis (50.9%) and a change in systemic therapy (41.5%). Likewise, virtual teledermatology consultation would have resulted in a change in diagnosis (54.7%) and a change in systemic therapy (47.2%) at similar rates. Comparing the dermatologist and teledermatologists, diagnostic complete and partial agreement were 52.8% and 84.9%, respectively. Systemic therapy agreement was 77.4%. Teledermatologists recommended biopsy more often (68.5% vs 43.5%). LIMITATIONS Small sample size, tertiary academic medical center, single rater for inpatient teledermatology with specific inpatient niche. CONCLUSION Teledermatologists performed comparably to an in-person dermatologist for the diagnosis and management of hospitalized patients with skin conditions. Teledermatology may be a suitable alternative for delivery of inpatient care if no dermatologist is available.

中文翻译：

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住院远程皮肤病学：使用存储和转发远程皮肤病学的医院，皮肤科医生和远程皮肤病医生之间的诊断和治疗一致性。

背景技术已经证明住院皮肤病学以降低的成本改善了患者的预后。很少有医院提供皮肤科医生。远程皮肤科可使皮肤科医生远程评估住院患者。目的探讨使用存储转发远距离皮肤病学的医院，皮肤科医生和远距离皮肤病医生之间的诊断一致性。方法对于所有100位需要住院皮肤科咨询的患者，所有3位评估者进行了一项调查，以传达诊断印象和治疗建议。使用Cohen kappa统计量评估完整和部分协议。结果住院皮肤科咨询通常会导致诊断改变（50.9％）和全身治疗改变（41.5％）。同样 虚拟远程皮肤科会诊会以相似的比率导致诊断改变（54.7％）和全身治疗改变（47.2％）。比较皮肤科医生和远程皮肤科医生，诊断完全和部分同意率分别为52.8％和84.9％。全身治疗率为77.4％。皮肤科医生建议穿刺活检的频率更高（68.5％对43.5％）。局限性样本量小，大学学术医学中心，具有特定住院利基位的住院远程皮肤病学的单一评估者。结论在皮肤病住院患者的诊断和管理方面，远程皮肤科医生的表现与亲自皮肤科医生相当。如果没有皮肤科医生，远程皮肤病可能是提供住院治疗的合适替代方法。2％）。比较皮肤科医生和远程皮肤科医生，诊断完全和部分同意率分别为52.8％和84.9％。全身治疗率为77.4％。皮肤科医生建议穿刺活检的频率更高（68.5％对43.5％）。局限性样本量小，大学学术医学中心，具有特定住院利基位的住院远程皮肤病学的单一评估者。结论在皮肤病住院患者的诊断和管理方面，远程皮肤科医生的表现与亲自皮肤科医生相当。如果没有皮肤科医生，远程皮肤病可能是提供住院治疗的合适替代方法。2％）。比较皮肤科医生和远程皮肤科医生，诊断完全和部分同意率分别为52.8％和84.9％。全身治疗率为77.4％。皮肤科医生建议穿刺活检的频率更高（68.5％对43.5％）。局限性样本量小，大学学术医学中心，具有特定住院利基位的住院远程皮肤病学的单一评估者。结论在皮肤病住院患者的诊断和管理方面，远程皮肤科医生的表现与亲自皮肤科医生相当。如果没有皮肤科医生，远程皮肤病可能是提供住院治疗的合适替代方法。皮肤科医生建议穿刺活检的频率更高（68.5％对43.5％）。局限性样本量小，大学学术医学中心，具有特定住院利基位的住院远程皮肤病学的单一评估者。结论在皮肤病住院患者的诊断和管理方面，远程皮肤科医生的表现与亲自皮肤科医生相当。如果没有皮肤科医生，远程皮肤病可能是提供住院治疗的合适替代方法。皮肤科医生建议穿刺活检的频率更高（68.5％对43.5％）。局限性样本量小，大学学术医学中心，具有特定住院利基位的住院远程皮肤病学的单一评估者。结论在皮肤病住院患者的诊断和管理方面，远程皮肤科医生的表现与亲自皮肤科医生相当。如果没有皮肤科医生，远程皮肤病可能是提供住院治疗的合适替代方法。