Obstacles hindering the mainstream practice of teledermatopathology

While the authors mention similar diagnostic accuracy for this technology compared with conventional microscopy, regulatory, licensing and reimbursement issues remain a concern, echoing the needs highlighted by Dr. Tim Allen on Digital Pathology and Federalism (PDF download) expressed earlier this year in Archives of Pathology and Laboratory Medicine (HTML full text to article).

Authors:    Giambrone D, Department of Dermatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey. Rao BK, Department of Dermatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Citation:   J. Am. Acad. Dermatol. 2014(Jun)

BACKGROUND: Teledermatopathology has the potential to link underserved areas to experts across the country and assist in making quick diagnoses, which may improve health care costs and delivery. Despite these potential benefits, teledermatopathology is not used routinely for primary diagnosis in the United States.

OBJECTIVE: To assess the current status of and address the potential for improving health care by the use of teledermatolopathology for primary diagnosis.

METHODS: Current available literature and online resources were reviewed to address 3 major variables that hinder the widespread use of teledermatopathology: diagnostic accuracy, licensure requirements, and reimbursement.

RESULTS: Recent studies show similar diagnostic accuracy for this technology compared to conventional microscopy. State-to-state variation and ambiguity in laws serve as the biggest hurdles to the widespread use of teledermatopathology. More states are recognizing the importance of the implementation of specific laws regarding telemedicine. More studies are required to evaluate the systems that offer specific telemedicine licenses, in addition to those that pay for telemedicine services specifically.

LIMITATIONS: This study reviewed current legislation concerning teledermatopathology; these laws are subject to revision.

CONCLUSION: Improving diagnostic accuracy and limiting variations in policy and reimbursement may encourage more pathologists to use teledermatopathology technology.