Effectiveness of Teledermatology in Clinical, Patient, and Operational Outcomes: A Systematic Review

INTRODUCTION: Teledermatology (TD), the remote diagnosis and management of skin conditions using digital platforms, has rapidly evolved since its initial adoption in 1995. With the onset of the COVID-19 pandemic, the utilization of TD expanded significantly, offering a viable alternative to face-to-face (F2F) consultations, particularly in settings where access to dermatologists are limited. OBJECTIVES: This systematic review aimed to evaluate the effectiveness of TD across three key domains: clinical outcomes, patient satisfaction, and cost-effectiveness. METHODS: A systematic search was conducted across MEDLINE, Embase, and Web of Science for studies published between 2010 and July 2024. Studies comparing TD with in-person consultations in terms of diagnostic accuracy, patient satisfaction, and cost-effectiveness were included. The quality of the included studies were as assessed using the Newcastle-Ottawa Scale (NOS). RESULTS: From 2,768 articles, 23 studies met the inclusion criteria. Clinical outcomes indicated moderate agreement between TD and F2F consultations, with a mean kappa coefficient of 0.57, reflecting diagnostic concordance. Patient satisfaction varied widely, with 26.57% of patients willing to replace F2F consultations with TD. TD was associated with significant cost savings, averaging US$81.31 per patient, with percentage savings ranging from 6.27% to 45.33%, depending on the healthcare system. CONCLUSIONS: TD provides moderate diagnostic accuracy, substantial cost savings, and varying degrees of patient acceptance. However, successful implementation requires high-quality imaging, clinician training, and robust technical infrastructure. Further research is needed to optimize TD's role in dermatology, particularly in balancing virtual and F2F care.