{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T17:48:29Z","timestamp":1784137709493,"version":"3.55.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2024,5,1]],"date-time":"2024-05-01T00:00:00Z","timestamp":1714521600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Telemedicine and e-Health"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Teledermatology adoption continues to increase, in part, spurred by the COVID-19 pandemic. This study analyzes the utility and cost savings of a store-and-forward teledermatology consultative system within the Veterans Health Administration (VA).<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Retrospective cohort of 4,493 patients across 14 remote sites in Tennessee and Kentucky from May 2017 through August 2019. The study measured the agreement between the teledermatology diagnoses and follow-up face-to-face clinic evaluations as well as the cost effectiveness of the teledermatology program over the study period.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Fifty-four percent of patients were recommended for face-to-face appointment for biopsy or further evaluation. Most patients, 80.5% received their face-to-face care by a VA dermatologist. There was a high level of concordance between teledermatologist and clinic dermatologist for pre-malignant and malignant cutaneous conditions. Veterans were seen faster at a VA clinic compared with a community dermatology site. Image quality improved as photographers incorporated teledermatologist feedback. From a cost perspective, teledermatology saved the VA system $1,076,000 in community care costs.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion:<\/jats:title>\n                    <jats:p>\n                      <jats:italic toggle=\"yes\">Teledermatology is a useful diagnostic tool within the VA system providing Veteran care at a cost savings.<\/jats:italic>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/tmj.2022.0528","type":"journal-article","created":{"date-parts":[[2023,12,27]],"date-time":"2023-12-27T16:35:16Z","timestamp":1703694916000},"page":"1411-1417","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["The Teledermatology Experience: Cost Savings and Image Quality Control"],"prefix":"10.1177","volume":"30","author":[{"given":"Matthew M.","family":"Wallace","sequence":"first","affiliation":[{"name":"Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Administration Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amber J.","family":"Hackstadt","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zijun","family":"Zhao","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Patrinely","sequence":"additional","affiliation":[{"name":"Vanderbilt University School of Medicine, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Zic","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Administration Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darrel","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Administration Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lynn","family":"Paul","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miliyard","family":"Sultan","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brandon","family":"Danford","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Administration Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3937-7038","authenticated-orcid":false,"given":"Allison M.","family":"Hanlon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Tennessee Valley Healthcare System, Nashville Veterans Administration Medical Center, Nashville, Tennessee, USA."},{"name":"Department of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,5,2]]},"reference":[{"issue":"1","key":"e_1_3_3_2_2","first-page":"42","article-title":"Teledermatology: One application of telemedicine","volume":"83","author":"Perednia DA","year":"1995","unstructured":"Perednia DA, , Brown NA. Teledermatology: One application of telemedicine. Bull Med Libr Assoc, 1995; 83(1):42\u201347.","journal-title":"Bull Med Libr Assoc"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.07.061"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2017.0253"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2017.06.002"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2000.03895.x"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2018.0242"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.04.011"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.08.026"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2016.4361"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X15586701"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2019.05.090"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1089\/153056203772744671"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/ijd.12909"},{"key":"e_1_3_3_15_2","unstructured":"Oh DH Weinstock MA. Teledermatlogy improves rural Veterans access to expert skin care. The Rural Connection Office of Rural Health 2018. Available from: https:\/\/www.ruralhealth.va.gov\/newsroom\/newsletter.asp [Last accessed: December1 2023]."},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.11.892"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2014.11.001"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X12474961"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.16275"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.108"},{"issue":"8","key":"e_1_3_3_21_2","first-page":"22014313","article-title":"Appointment wait times for specialty care in Veterans health administration facilities vs","volume":"3","author":"Griffith KN","year":"2020","unstructured":"Griffith KN, , Ndugga NJ, , Pizer SD. Appointment wait times for specialty care in Veterans health administration facilities vs. community medical centers. JAMA Network Open, 2020; 3(8):22014313.","journal-title":"community medical centers. 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