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This study will measure the impact of two teledermatology apps, VA Telederm and MY Telederm, WITH TWO SEPARATE TRIALS on access to dermatology care. The overall hypothesis is that sites implementing Department of Veterans Affairs' (VA) teledermatology mobile apps will significantly augment the use of teledermatology and improve Veterans' access to skin care relative to control sites. Specifically, the investigators hypothesize that VA Telederm will facilitate the implementation and adoption of teledermatology among primary care clinic staff, increasing use by existing programs and potentially expanding teledermatology to new sites while reducing patient travel to dermatology clinics. Additionally the investigators hypothesize that My Telederm will improve established patients' ability to follow-up with dermatology care remotely, while opening up dermatology clinic space for other patients.
Access to healthcare is currently a key priority for the Department of Veterans Affairs (VA). The current practice of teledermatology in VA is effective but has not been uniformly implemented, and inefficiencies in the current workstation-based process may discourage teledermatology adoption by primary care clinics. VA Office of Connected Care developed a mobile app, VA Telederm, as a more facile and efficient option that may enhance teledermatology adoption among providers. Once patients establish care in a dermatology clinic, they often need follow-up visits to evaluate responses to treatment and to adjust management, neither of which necessarily requires a face-to-face visit. To address these issues, OCC has additionally developed the My Telederm app to allow established dermatology clinic patients to follow-up in person, the app may improve clinic access to in-person dermatology clinics. The mobile apps are thus new programs that are planned for wide-spread implementation in the VA. The investigators will conduct TWO SEPARATE TRIALS of database reviews to understand how these two apps affect features of dermatology care, specifically related to access to care.
Both apps will be made available over a 2 year period in a randomized, stepped-wedge design to Veterans Health Administration (VHA) facilities. The VA Telederm app will be distributed to 36 eligible VHA facilities that currently have low teledermatology activity and thus have had relatively poor adoption of basic consultative teledermatology. The My Telederm app will be distributed to 24 facilities with dermatology clinics that currently have relatively high teledermatology activity and thus already have relatively mature teledermatology programs ready for advanced operations.
By using health factors and stop codes unique to each app, the investigators will use the VA Corporate Data Warehouse (CDW) to measure the impact of both apps in two separate trials on outcomes reflecting dermatology access. At the end of the study period, the proposed research will result in a novel documentation of mobile teledermatology's effectiveness in enhancing Veteran's access to dermatology service. The results will be of significance to VA as it develops and implements other mobile telehealth programs, and more generally to other healthcare organizations planning for large-scale telehealth interventions.
Introduction of Teledermatology Mobile Apps
VA Telederm mobile app introduction, My Telederm mobile app introduction
San Francisco VA Medical Center, San Francisco, CA
Not yet recruiting
VA Office of Research and Development
Published on BioPortfolio: 2017-08-07T13:53:21-0400
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