Consensus Guidance for Teledermatology: A Review (Preprint)

BACKGROUND Consensus guidelines and recommendations play an important role in fostering quality, safety, and best practices, as they represent an expert interpretation of the biomedical literature and its application to practice. However, it is unclear whether the recent collective experience of implementing telemedicine and the concurrent growth in the evidence base for teledermatology have resulted in more robust guidance. OBJECTIVE The objective of this review was to describe the extent and nature of currently available guidance, defined as consensus guidelines and recommendations, available for the practice of telemedicine in dermatology, with guidance defined as consensus or evidence-based guidelines, protocols, or recommendations. METHODS We conducted a single-reviewer scoping review of the literature to assess the extent and nature of available guidance, consensus guidelines, or recommendations related to teledermatology. We limited the review to published material in the English language, since 2013, reflecting approximately the past ten years. We conducted the review in November and December of 2022. RESULTS We identified 839 potentially eligible publications, with an additional nine records identified via a grey literature search. Fifteen publications met the inclusion and exclusion criteria. The guidelines focused on varied topics and populations concerning dermatology and skin diseases. However, the most frequent focus was general dermatology (53%). Approximately half of the telemedicine guidance described in the publications was specific to dermatology practice in the context of the COVID-19 pandemic, and the publications were largely published in or after the year 2020 (13/15, 87%). Geographical origin spanned several different nations, including Australia, the United States, European nations, and India. CONCLUSIONS We found an increase in COVID-19 specific teledermatology guidance during 2020, in addition to general teledermatology guidance during the time period of the study. Primary sources of general teledermatology guidance, reported in the biomedical literature, are the University of Queensland’s Centre for Online Health and Australasian College of Dermatologists E-Health Committee, and the American Telemedicine Association. There is strong evidence of international engagement and interest. Despite the recent increase in research reports related to telemedicine, there is a relative lack of new guidance based upon COVID-19 lessons and innovations. Clearly, there is a need to review recent evidence and update existing recommendations. Additionally, there is a need for guidance that addresses emerging technologies.