HX12 The evolution of teledermatology

Abstract

The term ‘teledermatology’ was first coined by Perednia and Brown in 1995, following a pilot telemedicine programme designed to deliver specialist dermatological care to geographically isolated and underserved populations in Oregon. However, the practice itself predates its formal nomenclature. The earliest documented teledermatology project occurred in 1972, involving real-time video transmission of clinical images from the Logan International Airport Medical Station to dermatologists in Massachusetts General Hospital. Over a decade later in 1989, Norway pioneered routine implementation of teledermatology into medical practice by adopting two-way video and telephone networks to link the University Hospital of North Norway in Tromsø with a primary care centre in Kirkenes. Although the feasibility of teledermatology was demonstrated in 1972, the first formal evaluation of diagnostic accuracy occurred in a Minnesota nursing home in 1997, which reported 88% concordance with on-site dermatologists. High diagnostic concordance, feasibility and positive patient perception led to explosive interest in teledermatology. By 2004, the UK introduced a regional teledermatology service, conducting 40 201 teleconsultations over 14 years, reducing 16 282 face-to-face appointments. By 2006, teledermatology was fully integrated into standard healthcare in the Netherlands, with KSYOS TeleMedical Centre performing 130 531 consultations between 2006 and 2015. By 2014, Spain had implemented teledermatology services into 25% of dermatology centres. Global implementation continues to expand markedly, rising from 16% of countries in 2009 to 46% in 2015, according to the WHO. Further, 48% of UK dermatologists currently use teledermatology in clinical practice, with 82% reporting prior experience with the modality. Looking forward, artificial intelligence (AI) is expected to further enhance teledermatology via automated triage, image quality assessment and preliminary diagnostic support. As teledermatology evolves to include AI-augmented systems, a key question remains: how far can digital innovation extend specialist dermatology services while still preserving diagnostic accuracy?