Store-and-Forward Teledermatology Using Mobile Phones: Clinical Efficacy in a Rural Primary Healthcare Centre Free Clinic Setting

Background: Technological advances increase the feasibility of mobile-phone teledermatology (mdermatology). By saving time and costs, underserved areas lacking dermatologists may benefit greatly. Objectives: To assess the clinical efficacy of mobile-phone store-and-forward mdermatology compared to face-to-face consultation. Methods: Patients from a rural health centre in Batangas were randomised to either mdermatology or face-to-face group. In the mdermatology group, a general practitioner (GP) assessed patients, took photographs using a cell phone camera and sent these via e-mail accessed via the GP’s mobile phone to the mdermatologist’s mobile phone. In the face-to-face group, the GP assessed patients and then referred them to the face-to-face dermatologist. Both the mdermatologist   and face-to-face dermatologist provided assessments and plans for patients in their respective groups. Clinical outcomes were assessed after two and four weeks. Results: A total of 123 patients were included, with 60 participants in the mdermatology group and 63 in the face-to-face group.  In both groups, most participants improved. There were no significant differences in clinical outcomes assessed by GPs (p=0.074), dermatologists (p=0.172), or participants (p=0.405). The diagnostic strength of agreement between the GP and the dermatologist differed between the two groups (Cohen’s κ=0.5775 vs. 0.2735), but management concordance was similar (p=0.775). Conclusion: Store-and-forward teledermatology using mobile phones in the dermatologic management of patients in a rural primary healthcare centre free clinic setting is feasible. This study did not find mobile teledermatology inferior to face-to-face consultation